Individual provider · Type 1 NPI
Cheryl Bastulli
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Eastlake, OH
Practice location
1135 E 346th St
Eastlake, OH 44095-2947
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver | 172A00000X | 274348 (OH) |
| Adult Day Care Clinic/Center | 261QA0600X | 274348 (OH) |
| Non-emergency Medical Transport (VAN) | 343900000X | 274348 (OH) |
| Private Vehicle | 347C00000X | 274348 (OH) |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 274348 (OH) |
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.
About NPI 1902402795
Cheryl Bastulli's National Provider Identifier is 1902402795, issued on Dec 8, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Eastlake, OH. The record was last updated on Dec 8, 2020.