NA

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

400360060504 Issued in OH

Legal business name

NA

Practice address

7629 Maryland Ave
Cleveland, OH 44105-5927

Phone

(216) 213-8084

NPI assigned

Dec 12, 2013

Organization subpart

No

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

Authorized official

Name

Tashia Fowlkes

Title

Stna

Phone

(216) 213-8084

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1750712956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7629 MARYLAND AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441055927",
            "telephone_number": "216-213-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 MARYLAND AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441055927",
            "telephone_number": "216-213-8084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "FOWLKES",
        "authorized_official_first_name": "TASHIA",
        "authorized_official_title_or_position": "STNA",
        "authorized_official_telephone_number": "216-213-8084"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OH",
            "license": "400360060504",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "400360060504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MZM Transport Inc.
• N Alliance Transit LLC
• N Stiles Medical Transport LLC
• N. Stephen Wilson, D.D.S.
• N/a
• Robert Naami, MD
• Leon Naar, MD
• Wallanda Nabaa
• Seyed Amin Please Select Nabavi, MD
• Syed Riaz-Un Nabi

• Adult Care Home Facility in Cleveland, OH
• Providers in Cleveland, 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 12, 2013; 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.