| Hispanic Umadaop | |
|
2202 Prame Ave Cleveland OH 44109 | |
| (440) 876-7806 | |
| Not Available |
| Full Name | Hispanic Umadaop |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2202 Prame Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Victor Owen Phillips (COUNSELOR/CASE MANAGER) |
| Authorized Official Contact | 2163513833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hispanic Umadaop 384 Prospect St. Berea OH 44017 Ph: () - | Hispanic Umadaop 2202 Prame Ave Cleveland OH 44109 Ph: (440) 876-7806 |
| NPI Number | 1982054458 |
|---|---|
| Provider Enumeration Date | 06/15/2016 |
| Last Update Date | 12/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982054458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 120988 (Ohio) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 120988 (Ohio) | Secondary |
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