Provider Demographics
NPI:1841460128
Name:KALEIDOSCOPE OF OHIO, LLC
Entity type:Organization
Organization Name:KALEIDOSCOPE OF OHIO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOIREFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-378-1359
Mailing Address - Street 1:24700 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5647
Mailing Address - Country:US
Mailing Address - Phone:216-378-1359
Mailing Address - Fax:216-378-2855
Practice Address - Street 1:24700 CHAGRIN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5647
Practice Address - Country:US
Practice Address - Phone:216-378-1359
Practice Address - Fax:216-378-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health