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NPI Code Detail

MEDICARE: OHIO BUREAU OF DRUG ABUSE

MEDICARE: OHIO BUREAU OF DRUG ABUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency10085-MOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073058137
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO BUREAU OF DRUG ABUSE
Provider Business Mailing Address
First Line : 1127 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2805
Country : US
Telephone Number : 216-861-4246
Fax Number : 216-861-1156
Provider Business Practice Location Address
First Line : 1127 CARNEGIE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2805
Country : US
Telephone Number : 216-861-4246
Fax Number : 216-861-1156
Authorized Official
Title or Position : ASST DIR/DIR HR
Name : SUSAN E TEMPLAR
Credential :
Telephone Number : 216-861-4246
Provider Enumeration Date : 12/28/2016
Last Update Date : 12/28/2016

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Practice Location Address:
1127 CARNEGIE AVE
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1215471388 — JEFFREY RAWLINGS LISW-S
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1184168114 — JULIUS COOKE LICDC
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1255875993 — ANTOINETTE GRAY
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1760926307 — KAREN SCROGGINS LPN
Practice Location Address:
1127 CARNEGIE AVE
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Directions to “OHIO BUREAU OF DRUG ABUSE ” Practice Location

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