| Clear Space Supervision & Consulting LLC | |
|
1303 Autumn Ln Akron OH 44333-2101 | |
| (330) 289-2859 | |
| Not Available |
| Full Name | Clear Space Supervision & Consulting LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1303 Autumn Ln, Akron, Ohio |
| Authorized Official Name and Position | Erin E Lane-orentlikher (OWNER) |
| Authorized Official Contact | 3302892859 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Space Supervision & Consulting LLC 1303 Autumn Ln Akron OH 44333-2101 Ph: (330) 289-2859 | Clear Space Supervision & Consulting LLC 1303 Autumn Ln Akron OH 44333-2101 Ph: (330) 289-2859 |
| NPI Number | 1639705833 |
|---|---|
| Provider Enumeration Date | 03/19/2020 |
| Last Update Date | 03/19/2020 |
| Certification Date | 03/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639705833 | NPI | - | NPPES |
| 0214419 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Secondary |
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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