Provider Demographics
NPI:1902294994
Name:KENTIX DEVELOPMENTAL HEALTH LLC
Entity Type:Organization
Organization Name:KENTIX DEVELOPMENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SPITALERI
Authorized Official - Suffix:
Authorized Official - Credentials:AS,BA,MS
Authorized Official - Phone:330-949-0131
Mailing Address - Street 1:3439 ATTERBURY ST
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1115
Mailing Address - Country:US
Mailing Address - Phone:330-949-0131
Mailing Address - Fax:234-208-9894
Practice Address - Street 1:113 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3221
Practice Address - Country:US
Practice Address - Phone:330-949-0131
Practice Address - Fax:234-208-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child