Organization
CHILDREN'S COMMUNITY ACCESS PROGRAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY LYNN GIBSON LSW, MSW (CHIEF OPERATING OFFICER)
(216) 361-0633
Entity
Organization
Contact information
Practice address
5000 EUCLID AVE, SUITE 204, CLEVELAND, OH 44103-3749
(216) 361-0633
(216) 361-0644
Mailing address
5000 EUCLID AVE, SUITE 204, CLEVELAND, OH 44103-3749
(216) 361-0633
(216) 361-0644
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
0562
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12463
—
OH
Enumeration date
03/27/2006
Last updated
01/24/2008
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