| Monarch Lifeworks - Xanthos | |
|
21450 Fairmount Blvd Shaker Heights OH 44118-4808 | |
| (216) 371-5051 | |
| (216) 932-6704 |
| Full Name | Monarch Lifeworks - Xanthos |
|---|---|
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
| Location | 21450 Fairmount Blvd, Shaker Heights, Ohio |
| Authorized Official Name and Position | Adam G Jacobs (PRESIDENT) |
| Authorized Official Contact | 2169322800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Monarch Lifeworks - Xanthos 21450 Fairmount Blvd Shaker Heights OH 44118-4808 Ph: (216) 371-5051 | Monarch Lifeworks - Xanthos 21450 Fairmount Blvd Shaker Heights OH 44118-4808 Ph: (216) 371-5051 |
| NPI Number | 1871950709 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 06/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871950709 | NPI | - | NPPES |
| 31712 | Other | OH | OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES CERTIFICATE NUMBER |
| 0078929 | Medicaid | OH | |
| 1815525 | Other | OH | OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES FACILITY NUMBER |
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