Healthcare Provider Details

I. General information

NPI: 1306353560
Provider Name (Legal Business Name): WOMENS WELLNESS FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2018
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5159 FOWLER AVE
CLEVELAND OH
44127-1565
US

IV. Provider business mailing address

6114 FRANCIS AVE
CLEVELAND OH
44127-1339
US

V. Phone/Fax

Practice location:
  • Phone: 216-403-1702
  • Fax: 216-403-1702
Mailing address:
  • Phone: 216-403-1702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA RIOS
Title or Position: EXECUTIVE DIRECTOR
Credential: CDCA
Phone: 216-626-6114