Healthcare Provider Details

I. General information

NPI: 1295075018
Provider Name (Legal Business Name): YMCA OF GREATER CLEVELAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2013
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
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: 216-263-6837
  • Fax: 216-781-1337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number6889
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MARK GALLEGOS
Title or Position: BILLING MANAGER
Credential:
Phone: 440-871-6702