Provider Demographics
NPI:1902586027
Name:TREBOR MANAGEMENT OF CLEVLAND LLC
Entity type:Organization
Organization Name:TREBOR MANAGEMENT OF CLEVLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:FURRAITTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-510-9776
Mailing Address - Street 1:6327 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3913
Mailing Address - Country:US
Mailing Address - Phone:440-789-3441
Mailing Address - Fax:
Practice Address - Street 1:121 GLENN ST
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-1305
Practice Address - Country:US
Practice Address - Phone:330-510-9776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care