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Organization

CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY L. LONGVILLE (CHIEF ACCOUNTING OFFICER AND CONTRO)
(216) 636-7416
Entity
Organization

Contact information

Practice address
2801 MARTIN LUTHER KING JR DR, CLEVELAND, OH 44104-3815
(216) 636-5437
Mailing address
6801 BRECKSVILLE RD STE 20, INDEPENDENCE, OH 44131-5062
(216) 442-5579

Taxonomy

Speciality
Code
Description
License number
State
283XC2000X
Children's Rehabilitation Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
-------
WV
Enumeration date
01/26/2024
Last updated
01/26/2024
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