Organization
ELIZA BRYANT VILLAGE
Active
Organization
ELIZA BRYANT VILLAGE
Active
Parent organization
ELIZA BRYANT VILLAGE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELIZA BRYANT VILLAGE
Authorized official
MR. DANNY WILLIAMS JD, MNO, LNHA (PRESIDENT/CEO)
(216) 658-1821
Entity
Organization
Contact information
Practice address
7201 WADE PARK AVE., CLEAVELAND, OH 44103
(216) 361-6141
(216) 588-1982
Mailing address
7201 WADE PARK AVE., CLEAVELAND, OH 44103
(216) 361-6141
(216) 588-1982
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0612822
—
OH
Enumeration date
06/14/2019
Last updated
06/14/2019
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