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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS BENNETT (VP COMMUNITY SERVICES)
(216) 696-9077
Entity
Organization

Contact information

Practice address
1801 SUPERIOR AVE E STE 400, CLEVELAND, OH 44114
(216) 696-9077
(216) 696-0770
Mailing address
1801 SUPERIOR AVE E STE 400, CLEVELAND, OH 44114-2135
(216) 696-9077
(216) 696-0770

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center

Other

Enumeration date
10/13/2011
Last updated
05/26/2022
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