Organization
LAKESHORE INTERGENERATIONAL SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E. DAANE (CFO)
(216) 456-2086
Entity
Organization
Contact information
Practice address
18025 MARCELLA RD, CLEVELAND, OH 44119
(216) 456-2086
(216) 391-4770
Mailing address
18025 MARCELLA RD, CLEVELAND, OH 44119
(216) 456-2086
(216) 391-4770
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
07/29/2014
Last updated
09/06/2014
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