IndividualActive
Cheryl Bastulli
NPI 1902402795 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Eastlake, OH
Provider details
- NPI number
- 1902402795
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 274348 (OH)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 274348 (OH)
Residential Treatment Facilities
Other Service Providers
Ambulatory Health Care Facilities
Transportation Services
Transportation Services
Practice location
1135 E 346th St
Eastlake, OH 44095-2947
Phone: (440) 669-0640
Approximate (ZIP-level) locationGet directions
Mailing address
1135 E 346th St
Eastlake, OH 44095-2947
Registry dates
- Enumerated
- 2020-12-08
- Last updated
- 2020-12-08
- Certified
- 2020-12-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.