| Organization Name: | GERIATRIC SPECIALTY CARE LLC |
| NPI Number: | 1154574630 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALICIA WOLF (MANAGING MEMBER) |
| Mailing Address: | 2407 Becket Cir Stow |
| State: | OH US |
| Postal Code: | 442247027 |
| Phone Number: | 4406666457 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2008 |
| NPI Last Update Date: | 04/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | COA08023-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |