Organization
NORTHEAST REINTEGRATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE MOTYKA PH. D. (PSYCHOLOGIST)
(216) 771-6460
Entity
Organization
Contact information
Practice address
2675 E 30TH ST, CLEVELAND, OH 44115-3000
(216) 771-6460
(216) 623-0992
Mailing address
2675 E 30TH ST, CLEVELAND, OH 44115-3000
(216) 771-6460
(216) 623-0992
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5787
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GTMOTYKA
—
OH
Enumeration date
09/16/2014
Last updated
09/16/2014
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