Organization
JEFFREY P LAND LISW-S LLC
Active
Organization
JEFFREY P LAND LISW-S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PETER LAND (SOLE MBR)
(440) 251-0237
Entity
Organization
Contact information
Practice address
6449 WILSON MILLS RD, MAYFIELD VILLAGE, OH 44143-3443
(440) 442-8800
(440) 442-8804
Mailing address
7048 BENTLEY PL, PAINESVILLE, OH 44077-2212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0001755-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12624773
CAQH
OH
Enumeration date
02/11/2014
Last updated
02/11/2014
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