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Individual

JEREMIAH BERDIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PEER SUPPORTER

Contact information

Practice address
14445 BROADWAY AVE, CLEVELAND, OH 44125-1957
(216) 677-8177
Mailing address
14445 BROADWAY AVE, CLEVELAND, OH 44125-1957
(216) 677-8177

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
OH
175T00000X
Peer Specialist
Primary
0002620
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002620
OHMAS
OH
Enumeration date
06/20/2022
Last updated
12/12/2023
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