Organization
STELLA MARIS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT LEE SMITH PH.D. (EXECUTIVE DIRECTOR)
(216) 781-0550
Entity
Organization
Contact information
Practice address
1302 WINSLOW AVENUE, CLEVELAND, OH 44113-2333
(216) 781-0550
Mailing address
1320 WASHINGTON AVENUE, CLEVELAND, OH 44113-2333
(216) 781-0550
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12602
UPI
OH
Enumeration date
01/29/2007
Last updated
10/22/2011
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