Charisse Ali, LLC a Lasting Impression

NPI #1063008670 in Ashtabula, Ohio

Provider Information

NPI Number: 1063008670
Entity Type: Organization
Organization Name: Charisse Ali, LLC a Lasting Impression
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 17, 2020
Last Updated: Dec 17, 2020

Practice Location

Address: 1440 W PROSPECT RD
City: Ashtabula
State: Ohio
ZIP Code: 44004-6668
Phone: (440) 319-2078

Authorized Official

Name: MRS. CHARISSE LILLIAN ALI
Title: CEO/OWNER
Phone: (440) 319-2078

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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