Cleveland Funeral Home, Inc.

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

02103051 Issued in NY

Legal business name

CLEVELAND FUNERAL HOME, INC.

Doing business as

Cleveland Services

Practice address

404 Sherman St
Watertown, NY 13601-3947

Phone

(315) 788-6180

Fax

(315) 785-1905

NPI assigned

Jan 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lynn S. Cleveland

Title

President

Phone

(315) 788-6180

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cleveland Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033262928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013947",
            "telephone_number": "315-788-6180",
            "fax_number": "315-785-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 SHERMAN ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013947",
            "telephone_number": "315-788-6180",
            "fax_number": "315-785-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND FUNERAL HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEVELAND",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-788-6180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NY",
            "license": "02103051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02103051",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shana Clark, LPN
• Taylor Clark, PA-C
• Krista Hoisington Clarke, PT, DPT
• Tammy Jane Clarke, OTA
• Aiesha Clayton
• Todd D Clopper, MD
• David L Clough
• Mandy Clymans, OTA
• Andrew Charles Coalter, DDS
• Amy Marie Coburn, MA-SLP

• Non-emergency Medical Transport (VAN) in Watertown, NY
• Providers in Watertown, NY by specialty
• Non-emergency Medical Transport (VAN) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.