Healthcare Provider Details

I. General information

NPI: 1619797313
Provider Name (Legal Business Name): WATSON COMMUNITY HEALTH CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16603 HARVARD AVE
CLEVELAND OH
44128-2203
US

IV. Provider business mailing address

16603 HARVARD AVE
CLEVELAND OH
44128-2203
US

V. Phone/Fax

Practice location:
  • Phone: 216-375-1659
  • Fax:
Mailing address:
  • Phone: 216-999-7444
  • 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
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: YALEITA RENEE WATSON
Title or Position: CEO
Credential:
Phone: 216-375-1659