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

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

National Provider Directory

Tax ID family
Guadalupe Home (8 organizations share this tax ID)
Part of
Guadalupe Home

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2773137MedicaidOH

Other providers in Olmsted Falls, OH

All providers in Olmsted Falls, OH · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio

Sources for this page

Verify at the official NPI Registry.