Jordan Community Residential | |
2231 N Taylor Rd Cleveland Heights OH 44112-3044 | |
(216) 441-2496 | |
(216) 634-9611 |
Full Name | Jordan Community Residential |
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Speciality | Psychologist - Addiction (substance Use Disorder) |
Location | 2231 N Taylor Rd, Cleveland Heights, Ohio |
Authorized Official Name and Position | Tenisha Gant (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2164412496 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jordan Community Residential 2231 N Taylor Rd Cleveland Heights OH 44112-3044 Ph: (216) 441-2496 | Jordan Community Residential 2231 N Taylor Rd Cleveland Heights OH 44112-3044 Ph: (216) 441-2496 |
NPI Number | 1164068524 |
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Provider Enumeration Date | 11/20/2019 |
Last Update Date | 11/20/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164068524 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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