Healthcare Provider Details

I. General information

NPI: 1497871719
Provider Name (Legal Business Name): COMMUNITY ASSESSMENT AND TREATMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8411 BROADWAY AVE
CLEVELAND OH
44105-3932
US

IV. Provider business mailing address

8411 BROADWAY AVE
CLEVELAND OH
44105-3932
US

V. Phone/Fax

Practice location:
  • Phone: 216-441-0200
  • Fax: 216-441-3176
Mailing address:
  • Phone: 216-441-0200
  • Fax: 216-441-3176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number06663
License Number StateOH

VIII. Authorized Official

Name: ROXANNE WALLACE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 216-441-0200