Provider Demographics
NPI:1972553063
Name:VISITING NURSE ASSOCIATION OF CLEVELAND
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF CLEVELAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISTOSIK
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:216-902-7902
Mailing Address - Street 1:925 KEYNOTE CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-1869
Mailing Address - Country:US
Mailing Address - Phone:216-694-4232
Mailing Address - Fax:216-694-4162
Practice Address - Street 1:925 KEYNOTE CIR STE 300
Practice Address - Street 2:
Practice Address - City:BROOKLYN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44131-1869
Practice Address - Country:US
Practice Address - Phone:216-694-4232
Practice Address - Fax:216-694-4162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH367022OtherMEDICARE
OH9072202Medicaid
OH9072202Medicaid