Organization
HKKM
Active
Other names
jjhjkm
Organization subpart
No
Provider details
NPI number
Authorized official
TYHNGN HJH VHB (CEO)
(216) 789-6541
Entity
Organization
Contact information
Practice address
25151 EUCLID, CLEVELAND, OH 44120
(216) 857-4135
Mailing address
25151 EUCLID, CLEVELAND, OH 44120
(216) 857-4135
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
—
—
305R00000X
Preferred Provider Organization
Primary
—
OH
Other
Enumeration date
09/28/2012
Last updated
07/21/2022
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