1225096035 NPI number — BENJAMIN ROSE INSTITUTE ON AGING

Table of content: (NPI 1225096035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225096035 NPI number — BENJAMIN ROSE INSTITUTE ON AGING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BENJAMIN ROSE INSTITUTE ON AGING
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:
6
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:
1225096035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11890 FAIRHILL RD
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:
44120-1053
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-791-8000
Provider Business Mailing Address Fax Number:
216-373-1816

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11890 FAIRHILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44120-1053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-791-8000
Provider Business Practice Location Address Fax Number:
216-373-1816
Provider Enumeration Date:
05/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BRENNAN
Authorized Official First Name:
JANICE
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. VP & CFO
Authorized Official Telephone Number:
216-373-1602

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251S00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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