Provider Demographics
NPI:1528946969
Name:A M DAVISON ENTERPRISE LLC
Entity type:Organization
Organization Name:A M DAVISON ENTERPRISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-242-8360
Mailing Address - Street 1:12800 SHAKER BLVD STE 210C1080
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-2000
Mailing Address - Country:US
Mailing Address - Phone:216-242-8360
Mailing Address - Fax:
Practice Address - Street 1:20619 RANDOLPH PKWY
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7017
Practice Address - Country:US
Practice Address - Phone:216-242-8360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A M DAVISON ENTERPRISE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health