Healthcare Provider Details

I. General information

NPI: 1437795887
Provider Name (Legal Business Name): PEOPLE PLACES AND DREAMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 01/30/2023
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3214 PROSPECT AVE E
CLEVELAND OH
44115-2614
US

IV. Provider business mailing address

3214 PROSPECT AVE E
CLEVELAND OH
44115-2614
US

V. Phone/Fax

Practice location:
  • Phone: 216-910-9015
  • Fax: 216-910-9015
Mailing address:
  • Phone: 216-910-9015
  • Fax: 216-910-9015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: NAFISAH ALIM
Title or Position: EXECUTIVE DIRECTOR
Credential: LCDC III
Phone: 614-615-0395