Individual provider · Type 1 NPI

Annette Johnson-Rucker

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Cleveland, OH

NPI number 1558075242 Active

Practice location

3294 E 104th St
Cleveland, OH 44104-5646

Call (216) 322-3006 Map

Mailing address

1037 East Blvd
Cleveland, OH 44108-2972

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Another provider at this address

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Cleveland

See all in Cleveland →

About NPI 1558075242

Annette Johnson-Rucker's National Provider Identifier is 1558075242, issued on Jan 9, 2023. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Cleveland, OH. The record was last updated on Jan 9, 2023.