Organization
CITY OF CLEVELAND
Active
Other names
Cleveland Department of Public Health, J. Glen Smith Treatment Program
Organization subpart
No
Provider details
NPI number
Authorized official
MATT CARROLL (DIRECTOR, CDPH)
(216) 664-6790
Entity
Organization
Contact information
Practice address
11100 SAINT CLAIR AVE, J. GLEN SMITH HEALTH CENTER, CLEVELAND, OH 44108-1943
(216) 664-3891
Mailing address
1925 SAINT CLAIR AVE NE, CLEVELAND DEPARTMENT OF PUBLIC HEALTH, CLEVELAND, OH 44114-2028
(216) 664-3920
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1073
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073
ODADAS PROVIDER NUMBER
OH
Enumeration date
12/26/2006
Last updated
10/16/2008
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