# HISPANIC UMADAOP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982054458
- **Authorized official:** MR. VICTOR OWEN PHILLIPS CDCA (COUNSELOR/CASE MANAGER)
- **Authorized official phone:** (216) 351-3833

## Contact information

- **Practice address:** 2202 PRAME AVE, CLEVELAND, OH 44109
- **Practice address phone:** (440) 876-7806
- **Mailing address:** 384 PROSPECT ST., BEREA, OH 44017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 120988 | OH | Yes |
| 324500000X | Substance Abuse Rehabilitation Facility | 120988 | OH | — |

## Other

- **Enumeration date:** 06/15/2016
- **Last updated:** 12/28/2017