Healthcare Provider Details

I. General information

NPI: 1740867084
Provider Name (Legal Business Name): ALLIANT HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 04/29/2022
Certification Date: 04/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 LEE RD
SHAKER HEIGHTS OH
44120-5122
US

IV. Provider business mailing address

3535 LEE RD
SHAKER HEIGHTS OH
44120-5122
US

V. Phone/Fax

Practice location:
  • Phone: 216-417-6166
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: ADA NWORIE
Title or Position: CEO
Credential:
Phone: 440-364-7674