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Organization
PROFOUND REFLECTIONS
Active
Organization
PROFOUND REFLECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEAH WALLACE (DIRECTOR)
(216) 374-1546
Entity
Organization
Contact information
Practice address
1734 WICKFORD RD, CLEVELAND, OH 44112-1208
(216) 374-1546
Mailing address
1734 WICKFORD RD, CLEVELAND, OH 44112-1208
(216) 374-1546
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
302R00000X
Health Maintenance Organization
—
—
305R00000X
Preferred Provider Organization
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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