1700880325 NPI number — UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, INC.

Table of content: (NPI 1700880325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700880325 NPI number — UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700880325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10011 EUCLID AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44106-4701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-791-8363
Provider Business Mailing Address Fax Number:
216-721-3372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10011 EUCLID AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44106-4701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-791-8363
Provider Business Practice Location Address Fax Number:
216-721-3372
Provider Enumeration Date:
06/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
OTTER
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
216-791-8363

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 320600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1800224 . This is a "I/O WAIVER AND CAFS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 8959042 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com