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General NPI Number Information
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NPI Number | 1114080959
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Entity Type | Organization
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Legal Business Name | L'ARCHE CLEVELAND, INC.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11811 SHAKER BLVD SUITE 320
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City | CLEVELAND
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State | OH
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Zip | 44120-1931
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Country | US
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Telephone | 216-721-2614
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Fax | 216-229-2311
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Provider Business Mailing Address
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Address Line | PO BOX 20450
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City | CLEVELAND
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State | OH
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Zip | 44120-0450
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Country | US
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Telephone | 216-721-2614
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Fax | 216-229-2311
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | REBECCA BRADY
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Credential | RN
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Telephone | 216-721-2614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | OH
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