Healthcare Provider Details

I. General information

NPI: 1619053824
Provider Name (Legal Business Name): LOUIS STOKES CLEVELAND DEPARTMENT OF VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

20640 SELFRIDGE PKWY
HIGHLAND HILLS OH
44122-7042
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax: 216-707-5920
Mailing address:
  • Phone: 216-561-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHRISTEAN COTTINGHAM
Title or Position: COMMUNITY HEALTH NURSE COORDINATOR
Credential: RN
Phone: 216-791-3800