Provider Demographics
NPI:1134441595
Name:CHERUBIM CARING LLC
Entity type:Organization
Organization Name:CHERUBIM CARING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPN
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:330-573-1840
Mailing Address - Street 1:PO BOX 7445
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-0445
Mailing Address - Country:US
Mailing Address - Phone:330-573-1840
Mailing Address - Fax:330-956-3912
Practice Address - Street 1:775 KIPLING ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1433
Practice Address - Country:US
Practice Address - Phone:330-573-1840
Practice Address - Fax:330-956-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 095799 IV251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2859152Medicaid
OH1407003676OtherNPPES