Healthcare Provider Details

I. General information

NPI: 1558207928
Provider Name (Legal Business Name): CLEVELAND&CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11808 POPPY RD
ADELANTO CA
92301-4574
US

IV. Provider business mailing address

11808 POPPY RD
ADELANTO CA
92301-4574
US

V. Phone/Fax

Practice location:
  • Phone: 323-742-9335
  • Fax:
Mailing address:
  • Phone: 323-742-9335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MARY CLEVELAND
Title or Position: CEO
Credential:
Phone: 323-742-9335