Healthcare Provider Details

I. General information

NPI: 1942288303
Provider Name (Legal Business Name): DIABETES ASSOCIATION OF GREATER CLEVELAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 GREEN RD SUITE 100
CLEVELAND OH
44122-5725
US

IV. Provider business mailing address

PO BOX 123
NORTH OLMSTED OH
44070-0123
US

V. Phone/Fax

Practice location:
  • Phone: 216-591-0800
  • Fax:
Mailing address:
  • Phone: 440-777-6017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: HELEN DUMSKI
Title or Position: PRESIDENT
Credential:
Phone: 216-591-0800