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Organization

LILLIE'S HOME, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TAMIKA MOORE LISW-S (EXECUTIVE DIRECTOR)
(216) 200-6727
Entity
Organization

Contact information

Practice address
11811 SHAKER BLVD, STE 204 #1168, CLEVELAND, OH 44120-1927
(216) 200-6727
Mailing address
11811 SHAKER BLVD, STE 204 #1168, CLEVELAND, OH 44120-1927

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
1041C0700X
Clinical Social Worker
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
405300000X
Prevention Professional

Other

Enumeration date
07/22/2024
Last updated
07/22/2024
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