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NPI Code Detail

MEDICARE: DENESHA JORDAN

MEDICARE: DENESHA JORDAN
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 AgencyOH

General Provider Information

NPI Number : 1275466476
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENESHA JORDAN
Provider Business Mailing Address
First Line : 2415 GREENVALE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44121-1121
Country : US
Telephone Number : 216-825-5191
Fax Number :
Provider Business Practice Location Address
First Line : 2415 GREENVALE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44121-1121
Country : US
Telephone Number : 216-825-5191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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Directions to “ DENESHA JORDAN ” Practice Location

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