Healthcare Provider Details

I. General information

NPI: 1942058227
Provider Name (Legal Business Name): NEW LEAF BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10055 SWEET VALLEY DR STE 1
CLEVELAND OH
44125-4245
US

IV. Provider business mailing address

406 W 130TH ST
BRUNSWICK OH
44212-2310
US

V. Phone/Fax

Practice location:
  • Phone: 216-973-5018
  • Fax: 510-345-2137
Mailing address:
  • Phone: 216-973-5018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAMMY J BARR
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 216-973-5018