Provider Demographics
NPI:1316814056
Name:PPC ASSISTED LIVING LLC
Entity type:Organization
Organization Name:PPC ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-317-2141
Mailing Address - Street 1:15728 LORAIN AVE # 8061
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5542
Mailing Address - Country:US
Mailing Address - Phone:216-317-2141
Mailing Address - Fax:
Practice Address - Street 1:7816 WORLEY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3842
Practice Address - Country:US
Practice Address - Phone:216-317-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-18
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility