Healthcare Provider Details

I. General information

NPI: 1326625658
Provider Name (Legal Business Name): ALLIANT HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 04/28/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17603 EUCLID AVENUE
CLEVELAND OH
44112-4411
US

IV. Provider business mailing address

3535 LEE RD
SHAKER HEIGHTS OH
44120-5122
US

V. Phone/Fax

Practice location:
  • Phone: 216-417-6166
  • Fax: 216-417-8676
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ADA NWORIA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 216-417-6166