Organization
CARRINGTON YOUTH ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD F PAWLIKOWSKY (ADMINISTRATOR)
(216) 268-2400
Entity
Organization
Contact information
Practice address
2114 NOBLE RD, CLEVELAND, OH 44112-1725
(216) 268-2400
(216) 268-2460
Mailing address
2114 NOBLE RD, CLEVELAND, OH 44112-1725
(216) 268-2400
(216) 268-2460
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
13375
OH
251S00000X
Community/Behavioral Health Agency
Primary
13375
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0082618
—
OH
Enumeration date
04/11/2013
Last updated
06/07/2013
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