Organization
KOINONIA COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE BEASTROM (CEO)
(216) 588-8777
Entity
Organization
Contact information
Practice address
6161 OAK TREE BLVD, SUITE #400, INDEPENDENCE, OH 44131-2516
(216) 588-8777
(216) 588-5670
Mailing address
6161 OAK TREE BLVD, SUITE #400, INDEPENDENCE, OH 44131-2516
(216) 588-8777
(216) 588-5670
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
11/15/2008
Last updated
11/15/2008
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