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NPI Code Detail

MEDICARE: JACLYN TELEP QMHS

MEDICARE: JACLYN TELEP QMHS
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
1171M00000XCase Manager/Care Coordinator

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 : 1598271173
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN TELEP QMHS
Provider Business Mailing Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number : 216-831-2255
Fax Number :
Provider Business Practice Location Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number : 216-831-2255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2017
Last Update Date : 11/13/2025

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Directions to “ JACLYN TELEP QMHS” Practice Location

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