ROYAL BLAINE

CLEVELAND, OH
NPI1740781657
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  CDCA.164704)
Enumeration Date2018-02-26
Last Update Date2018-02-26
Business Address
ROYAL BLAINE CDCA, OBBC
3622 PROSPECT AVE E
CLEVELAND, OH 44115-2704
Phone number: 216-633-8733
Mailing Address
ROYAL BLAINE CDCA, OBBC
3798 GLENWOOD RD
CLEVELAND HEIGHTS, OH 44121-1650
Phone number: