Elizabeth Lane Home
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Olmsted Falls, OH
NPI 1891946901 · NPPES record last updated Oct 7, 2008
Key facts
- NPI
- 1891946901
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- License
- 1815541 (OH)
- Legal business name
- ELIZABETH LANE HOME
- Practice address
- 26926 Elizabeth LN
Olmsted Falls, OH 44138-1153 - Phone
- (440) 427-8336
- Fax
- (440) 427-8377
- NPI assigned
- Oct 7, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- OUR LADY OF THE WAYSIDE
Authorized official
- Name
- Mrs. Shirley Sharp
- Title
- Business Administrator
- Phone
- (440) 934-6152
Corporate family (same tax ID) 7
National Provider Directory
- Tax ID family
- Guadalupe Home
- Part of
- Guadalupe Home
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 1815541 | OH | Yes |
Addresses
Primary practice location
26926 Elizabeth LN
Olmsted Falls, OH 44138-1153
Mailing address
38135 Colorado Ave
Avon, OH 44011-1028
Phone (440) 934-6152
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2773137 | Medicaid | OH |
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All providers in Olmsted Falls, OH · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.