Provider Demographics
NPI:1831359967
Name:ELDERHOOD COMMUNITY SERVICES
Entity type:Organization
Organization Name:ELDERHOOD COMMUNITY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-871-0090
Mailing Address - Street 1:2116 DOVER CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3154
Mailing Address - Country:US
Mailing Address - Phone:440-871-0090
Mailing Address - Fax:440-871-7289
Practice Address - Street 1:2116 DOVER CENTER RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3154
Practice Address - Country:US
Practice Address - Phone:440-871-0090
Practice Address - Fax:440-871-7289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty