Eliza Jennings Services Corporation

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ELIZA JENNINGS SERVICES CORPORATION

Practice address

10603 Detroit Ave
Cleveland, OH 44102-1647

Phone

(216) 226-6090

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Denise Gannon, R.N.

Title

VP of Clinical Support

Phone

(216) 226-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Acacia Place Doing business as

Tax ID family

Acacia Place2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eliza Jennings Services Corporation

  • Home Health Agency
  • Olmsted TWP, OH
  • NPI 1467655944
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brittney Laverne Bulkowski, RN

  • Registered Nurse
  • Parma, OH
  • NPI 1205204393
  NPD

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598968570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10603 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021647",
            "telephone_number": "216-226-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10603 DETROIT AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441021647",
            "telephone_number": "216-226-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZA JENNINGS SERVICES CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VP OF CLINICAL SUPPORT",
        "authorized_official_telephone_number": "216-226-5000",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2623610",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acacia Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elite Dental Art Ghazal DDS LLC
• Elite for a Reason
• Elite Medical Mobility LLC
• Eliza Bryant Village
• Eliza Jennings Home
• Mohamed Elkahly, MD
• Mohamed Elkasaby, MD
• Amanda Elkins, RD, LD
• Cassidy Elkins, APRN-CNP
• Jamilyn Marie Eller, LMT

• Adult Day Care Clinic/Center in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Adult Day Care Clinic/Center in Ohio

• 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.