Healthcare Provider Details

I. General information

NPI: 1578135364
Provider Name (Legal Business Name): YMCA OF GREATER CLEVELAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 WOODLAND AVE STE 703
CLEVELAND OH
44104-2775
US

IV. Provider business mailing address

1301 E 9TH ST FL 2
CLEVELAND OH
44114-1804
US

V. Phone/Fax

Practice location:
  • Phone: 216-674-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 State

VIII. Authorized Official

Name: TIMOTHY MICHAEL HILK
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 216-263-6837