Organization
SIGNATURE HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN ALBERT LEE (CEO)
(440) 953-9999
Entity
Organization
Contact information
Practice address
4200 PARK AVE, 2ND FLOOR, ASHTABULA, OH 44004-6887
(440) 992-8552
(440) 992-8537
Mailing address
38879 MENTOR AVE, SUITE C, WILLOUGHBY, OH 44094-7992
(440) 953-9999
(440) 918-3839
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0467
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2325835
—
OH
Enumeration date
07/25/2006
Last updated
10/06/2009
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