Healthcare Provider Details

I. General information

NPI: 1477473734
Provider Name (Legal Business Name): PICTURE ME PERFECT YOUTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26300 EUCLID AVE
EUCLID OH
44132-3708
US

IV. Provider business mailing address

1799 WRENFORD RD
SOUTH EUCLID OH
44121-3127
US

V. Phone/Fax

Practice location:
  • Phone: 216-463-3148
  • Fax:
Mailing address:
  • Phone: 216-463-3148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AAHLIYAH MELTON
Title or Position: OWNER
Credential: MELTON
Phone: 216-463-3148