Organization
CUYAHOGA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY PETTY (SUPERINTENDENT)
(216) 736-2731
Entity
Organization
Contact information
Practice address
1275 LAKESIDE AVE., E., CLEVELAND, OH 44114
(216) 241-8230
(216) 861-0253
Mailing address
1275 LAKESIDE AVE., E., CLEVELAND, OH 44114
(216) 241-8230
(216) 861-0253
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1800019
—
OH
Enumeration date
12/01/2020
Last updated
12/01/2020
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