| NPI | 1902791775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA A BLACKMON Administrator/ Managing Member 216-260-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2025-06-11 |
| Last Update Date | 2025-06-27 |