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General NPI Number Information
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NPI Number | 1144572777
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Entity Type | Organization
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Legal Business Name | CLEVELAND RAPE CRISIS CENTER
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 526 SUPERIOR AVE E SUITE 1400
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City | CLEVELAND
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State | OH
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Zip | 44114-1902
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Country | US
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Telephone | 216-619-6194
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Fax | 216-619-6195
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Provider Business Mailing Address
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Address Line | 526 SUPERIOR AVE E SUITE 1400
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City | CLEVELAND
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State | OH
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Zip | 44114-1902
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Country | US
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Telephone | 216-619-6194
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Fax | 216-619-6195
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Authorized Official
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Title or Position | VICE PRESIDENT OF CLIENT & CLINICAL
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Name | MRS. KIRSTI MOUNCEY
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Credential | MSW, LISW-S, LCDCIII
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Telephone | 216-619-6194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | I0700212
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License Number State | OH
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