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NPI Code Detail

MEDICARE: NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.

MEDICARE: NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
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
1261QP2300XPrimary Care Clinic/Center

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 : 1922112960
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 13301 MILES AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44105-5521
Country : US
Telephone Number : 216-751-3100
Fax Number :
Provider Business Practice Location Address
First Line : 13301 MILES AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44105-5521
Country : US
Telephone Number : 216-751-3100
Fax Number : 216-751-2480
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MR. WILLIE F. AUSTIN
Credential :
Telephone Number : 216-231-7700
Provider Enumeration Date : 08/18/2006
Last Update Date : 04/11/2008

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Directions to “NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC. ” Practice Location

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