1225750151 NPI number — NEW AVENUES TO INDEPENDENCE INC.

Table of content: SHERYL GOODWIN REGISTERED NURSE (NPI 1417064627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225750151 NPI number — NEW AVENUES TO INDEPENDENCE INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW AVENUES TO INDEPENDENCE INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225750151
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3615 SUPERIOR AVENUE SUITE 4404A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-481-1909
Provider Business Mailing Address Fax Number:
216-481-2050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4745 VALLEYBROOK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRECKSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-481-1909
Provider Business Practice Location Address Fax Number:
216-481-2050
Provider Enumeration Date:
09/16/2022

Additional Information

Authorized Official

Authorized Official Last Name:
KNAVEL
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
216-767-4024

Provider Taxonomy Codes

  • Taxonomy code: 385HR2060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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