# CLEVELAND CLINIC SPORTS HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE CLEVELAND CLINIC FOUNDATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740616820
- **Legal business name:** THE CLEVELAND CLINIC FOUNDATION
- **Authorized official:** GARY MILLER (COORDINATOR OF AT)
- **Authorized official phone:** (216) 518-3429

## Contact information

- **Practice address:** 4683 WAYNE ROAD, MANTUA, OH 44255
- **Practice address phone:** (330) 274-8396
- **Mailing address:** 4683 WAYNE RD, MANTUA, OH 44255-9664
- **Mailing address phone:** (330) 274-8396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | AT. 004124 | OH | Yes |

## Other

- **Enumeration date:** 09/19/2013
- **Last updated:** 09/19/2013