Healthcare Provider Details

I. General information

NPI: 1578962957
Provider Name (Legal Business Name): LIFE SOLUTIONS SOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 01/31/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 EUCLID AVE STE 400
CLEVELAND OH
44115-2429
US

IV. Provider business mailing address

2728 EUCLID AVE STE 400
CLEVELAND OH
44115-2429
US

V. Phone/Fax

Practice location:
  • Phone: 216-236-3028
  • Fax: 800-901-0720
Mailing address:
  • Phone: 216-236-3028
  • Fax: 800-901-0720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: GIA HOPKINS
Title or Position: CE0/HUMAN RESOURCES
Credential:
Phone: 216-236-3028