Organization
WINGSPAN CARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH HALL (GENERAL COUNSEL)
(216) 320-8222
Entity
Organization
Contact information
Practice address
3518 W 25TH ST, CLEVELAND, OH 44109-1951
(216) 741-2241
Mailing address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0332211
—
OH
Enumeration date
01/27/2023
Last updated
01/27/2023
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