Healthcare Provider Details

I. General information

NPI: 1306393764
Provider Name (Legal Business Name): SAFY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20600 CHAGRIN BLVD, STE 900
SHAKER OH
44122
US

IV. Provider business mailing address

20600 CHAGRIN BLVD
BEACHWOOD OH
44122-5327
US

V. Phone/Fax

Practice location:
  • Phone: 216-295-7239
  • Fax:
Mailing address:
  • Phone: 216-295-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS ALYSSA MARIE DRAGOLICH
Title or Position: C
Credential: BSW
Phone: 440-527-4893