Healthcare Provider Details

I. General information

NPI: 1275598419
Provider Name (Legal Business Name): HITCHCOCK CENTER FOR WOMEN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 ANSEL RD
CLEVELAND OH
44108-3323
US

IV. Provider business mailing address

1227 ANSEL RD
CLEVELAND OH
44108-3323
US

V. Phone/Fax

Practice location:
  • Phone: 216-421-0662
  • Fax: 216-421-0911
Mailing address:
  • Phone: 216-421-0662
  • Fax: 216-421-0911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY BAZIE
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW,OCPSII,LISW
Phone: 216-421-0662