N/A

CLEVELAND, OH
NPI1932513694
Entity TypeOrganization
Authorized ContactCHRISTINA YVETTE BLAKE
Stna
216-937-9110
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: OH  401616630214)
Enumeration Date2014-06-19
Last Update Date2014-06-19
Business Address
N/A
8722 BECKMAN AVE
CLEVELAND, OH 44104-2337
Phone number: 216-937-9110
Mailing Address
N/A
8722 BECKMAN AVE
CLEVELAND, OH 44104-2337
Phone number: 216-937-9110