MEDICARE: FIRST RESORT PEER SUPPORT

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1851127195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST RESORT PEER SUPPORT

Provider Business Mailing Address
First Line	:	3301 ARCHMERE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5400
Country	:	US
Telephone Number	:	216-346-8608
Fax Number	:	216-273-7974

Provider Business Practice Location Address
First Line	:	3301 ARCHMERE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-5400
Country	:	US
Telephone Number	:	216-346-8608
Fax Number	:	216-273-7974

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ANGELA VIOLA JARRETT
Credential	:	LICDC
Telephone Number	:	216-346-8608

Provider Enumeration Date	:	09/12/2024
Last Update Date	:	09/08/2025

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Directions to “FIRST RESORT PEER SUPPORT ” Practice Location

Language	Start Address	Practice Location

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