| Community Action Against Addiction | |
|
5209 Euclid Ave Cleveland OH 44103-3703 | |
| (216) 881-0765 | |
| (216) 431-2190 |
| Full Name | Community Action Against Addiction |
|---|---|
| Speciality | Counselor |
| Location | 5209 Euclid Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Robert J Moore (CEO) |
| Authorized Official Contact | 2168810765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Action Against Addiction 5209 Euclid Ave Cleveland OH 44103-3703 Ph: (216) 881-0765 | Community Action Against Addiction 5209 Euclid Ave Cleveland OH 44103-3703 Ph: (216) 881-0765 |
| NPI Number | 1083672372 |
|---|---|
| Provider Enumeration Date | 05/03/2006 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Medicare PECOS PAC ID | 5890922165 |
|---|---|
| Medicare Enrollment ID | O20131211001336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083672372 | NPI | - | NPPES |
| 1853901 | Medicaid | OH | |
| 2942641 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 020249850 (Ohio) | Primary |
| Provider Name | Theodore V Parran |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1811974348 PECOS PAC ID: 4385819846 Enrollment ID: I20111212000415 |
| Provider Name | Joseph F Lydon |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1598766859 PECOS PAC ID: 5698663888 Enrollment ID: I20151223000345 |
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