Provider Demographics
NPI:1043506173
Name:CUMMINGS, WALCOTT AND DAVID CORP
Entity type:Organization
Organization Name:CUMMINGS, WALCOTT AND DAVID CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EULAH
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:216-224-1425
Mailing Address - Street 1:3240 E 116TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3840
Mailing Address - Country:US
Mailing Address - Phone:216-224-1425
Mailing Address - Fax:570-685-1343
Practice Address - Street 1:20109 LONGBROOK RD
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-2826
Practice Address - Country:US
Practice Address - Phone:570-906-4437
Practice Address - Fax:570-685-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home