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Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FRANCIS J. MATESE PH.D. (CLINICAL DIRECTOR)
(216) 267-7070
Entity
Organization

Contact information

Practice address
5131 W 140TH ST, BROOK PARK, OH 44142-1755
(216) 267-7070
(216) 267-7075
Mailing address
5131 W 140TH ST, BROOK PARK, OH 44142-1755
(216) 267-7070
(216) 267-7075

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0629
OH

Other

Enumeration date
09/09/2008
Last updated
09/12/2008
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