Healthcare Provider Details
I. General information
NPI: 1962235580
Provider Name (Legal Business Name): TOUCH OF HOPE CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7017 PEARL RD STE 1F
CLEVELAND OH
44130-4935
US
IV. Provider business mailing address
4758 RIDGE RD # 417
BROOKLYN OH
44144-3327
US
V. Phone/Fax
- Phone: 216-659-1661
- Fax:
- Phone: 216-659-1661
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
DANIELLE
D
DAVIS
Title or Position: CEO
Credential: LSW
Phone: 216-659-1661