Provider Demographics
NPI:1962395145
Name:LAWRENCE AZIZA LLC
Entity type:Organization
Organization Name:LAWRENCE AZIZA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:B
Authorized Official - Last Name:HALES
Authorized Official - Suffix:
Authorized Official - Credentials:BS BUSINESS ADMIN
Authorized Official - Phone:216-276-5482
Mailing Address - Street 1:PO BOX 391636
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-8636
Mailing Address - Country:US
Mailing Address - Phone:234-400-4999
Mailing Address - Fax:
Practice Address - Street 1:1893 WYMORE AVE
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3913
Practice Address - Country:US
Practice Address - Phone:234-400-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services