Individual
LOVEL HENDERSON JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
JR.
Contact information
Practice address
6600 LEXINGTON AVE, CLEVELAND, OH 44103
(216) 355-8331
Mailing address
1769 EAST 63RD STREET, CLEVELAND, OH 44103
(216) 355-8331
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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