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Individual

RILEY SIMPLICAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CDCA

Contact information

Practice address
1804 E 55TH ST, CLEVELAND, OH 44103-3602
(216) 417-4213
Mailing address
1804 E 55TH ST, CLEVELAND, OH 44103-3602

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CDCA.176354
OH

Other

Enumeration date
04/25/2021
Last updated
04/25/2021
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