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Organization
NEW MANNA CLG, LLC
Active
Organization
NEW MANNA CLG, LLC
Active
Parent organization
NEW MANNA CLG LLC
Other names
Lake Health Beachwood Allied Health Professionals
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW MANNA CLG LLC
Authorized official
MICHELLE GALLUCCI (VP CHIEF ACCOUNTING OFFICER)
(440) 382-7894
Entity
Organization
Contact information
Practice address
25501 CHAGRIN BLVD, BEACHWOOD, OH 44122-5603
(216) 545-4800
Mailing address
PO BOX 74769, CLEVELAND, OH 44194-0852
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/21/2019
Last updated
03/23/2026
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