Healthcare Provider Details

I. General information

NPI: 1023630761
Provider Name (Legal Business Name): WINTER SPRING HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2020
Last Update Date: 05/16/2020
Certification Date: 05/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13509 HIGHLANDVIEW AVE
CLEVELAND OH
44135-1622
US

IV. Provider business mailing address

13509 HIGHLANDVIEW AVE
CLEVELAND OH
44135-1622
US

V. Phone/Fax

Practice location:
  • Phone: 216-762-0303
  • Fax:
Mailing address:
  • Phone: 216-762-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LISA RUCKER
Title or Position: OWNER
Credential:
Phone: 216-762-0303