Organization
B. RILEY SOBER HOUSE
Active
Other names
B. Riley House
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL ANTONIO CORREA (FOUNDER/ EXECUTIVE DIRECTOR)
(216) 417-4831
Entity
Organization
Contact information
Practice address
2121 W 117TH ST, CLEVELAND, OH 44111-1642
(216) 417-4831
(216) 417-0040
Mailing address
2121 W 117TH ST, CLEVELAND, OH 44111-1642
(216) 417-4831
(216) 417-0040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0454981
—
OH
Enumeration date
05/16/2023
Last updated
09/12/2023
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