Organization
DEBALZO ELGUDIN LEVINE RISEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARISSA ELGUDIN MD (CO-DIRECTOR)
(216) 831-2900
Entity
Organization
Contact information
Practice address
23425 COMMERCE PARK, SUITE 104, BEACHWOOD, OH 44122-5844
(216) 831-2900
(216) 831-4306
Mailing address
23425 COMMERCE PARK, SUITE 104, BEACHWOOD, OH 44122-5844
(216) 831-2900
(216) 831-4306
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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