Organization
CLEVELAND CHRISTIAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LUNDEEN (CEO)
(216) 671-0997
Entity
Organization
Contact information
Practice address
11401 LORAIN AVE, CLEVELAND, OH 44111-5428
(216) 688-4129
(216) 941-2080
Mailing address
3146 SCRANTON RD, CLEVELAND, OH 44109-1652
(216) 688-4129
(216) 941-2080
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10258
UPI
OH
05
—
2847209
—
OH
Enumeration date
12/13/2011
Last updated
12/13/2011
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