Provider First Line Business Practice Location Address:
JORDAN COMMUNITY RESIDENTIAL CENTER
Provider Second Line Business Practice Location Address:
2231 NORTH TAYLOR RD
Provider Business Practice Location Address City Name:
CLEVELAND HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-441-2496
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2017