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Organization
NEIGHBORING
Active
Organization
NEIGHBORING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. W SPENCE KLINE III JD MED LPC (CHIEF EXECUTIVE OFFICER)
(440) 354-9924
Entity
Organization
Contact information
Practice address
5930 HEISLEY RD, MENTOR, OH 44060-1834
(440) 354-9924
Mailing address
5930 HEISLEY RD, MENTOR, OH 44060-1834
(440) 354-9924
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2362429
—
OH
Enumeration date
05/23/2006
Last updated
08/22/2020
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