Healthcare Provider Details
I. General information
NPI: 1346034535
Provider Name (Legal Business Name): WATSON COMMUNITY HEALTH CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
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
- Phone: 216-999-7444
- Fax: 216-999-7034
- Phone: 216-999-7444
- Fax: 216-999-7034
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YALEITA
RENEE
WATSON
Title or Position: CEO
Credential: FNP
Phone: 216-999-7444