Organization
COLLABORATION STATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHERYL J SMITH (EXECUTIVE DIRECTOR)
(216) 777-2136
Entity
Organization
Contact information
Practice address
4614 PROSPECT AVE STE 325, CLEVELAND, OH 44103-4377
(216) 777-2136
Mailing address
4614 PROSPECT AVE, SUITE 325, CLEVELAND, OH 44103-4394
(216) 777-2136
(888) 380-3849
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
1310918
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163026
—
OH
Enumeration date
11/16/2016
Last updated
07/21/2022
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