Tenisha Glass

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

400078860202 Issued in OH

Legal business name

TENISHA GLASS

Practice address

20371 Lorain Rd Apt E5
Fairview Park, OH 44126-3455

Phone

(216) 551-1822

NPI assigned

Dec 28, 2015

Organization subpart

No

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

Authorized official

Name

Tenisha Glass

Title

Sole

Phone

(216) 551-1822

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1451260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1053776575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20371 LORAIN RD APT E5",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263455",
            "telephone_number": "216-551-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20371 LORAIN RD APT E5",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263455",
            "telephone_number": "216-551-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENISHA GLASS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-28",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "TENISHA",
        "authorized_official_title_or_position": "SOLE",
        "authorized_official_telephone_number": "216-551-1822"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "400078860202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3062939",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Optical Inc
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• Adult Care Home Facility in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Adult Care Home Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.