Healthcare Provider Details

I. General information

NPI: 1598595407
Provider Name (Legal Business Name): SERVICES X LB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3414 W 44TH ST # UP
CLEVELAND OH
44109-1034
US

IV. Provider business mailing address

3414 W 44TH ST # UP
CLEVELAND OH
44109-1034
US

V. Phone/Fax

Practice location:
  • Phone: 216-858-9588
  • Fax:
Mailing address:
  • Phone: 216-858-9588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORIN FRANKLIN
Title or Position: OWNER
Credential:
Phone: 216-309-0570