Organization
GBEHZON COMMUNITY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMMON O. B. LOGAN SR. (CEO/PRESIDENT)
(951) 413-4908
Entity
Organization
Contact information
Practice address
1031 ANSEL RD, CLEVELAND, OH 44103-2261
(951) 413-4908
Mailing address
18009 LAKE SHORE BLVD APT 303, CLEVELAND, OH 44119-1244
(951) 413-4908
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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