Provider Demographics
NPI:1588138341
Name:KEMPER CENTER FOR COGNITIVE HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:KEMPER CENTER FOR COGNITIVE HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-472-4200
Mailing Address - Street 1:10307 DETROIT AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-1605
Mailing Address - Country:US
Mailing Address - Phone:216-472-4200
Mailing Address - Fax:216-472-4220
Practice Address - Street 1:10890 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-2256
Practice Address - Country:US
Practice Address - Phone:440-846-1100
Practice Address - Fax:440-846-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center