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General NPI Number Information
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NPI Number | 1154814051
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Entity Type | Organization
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Legal Business Name | COMMUNITY ACTION AGAINST ADDICTION
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 5209 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-3703
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Country | US
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Telephone | 216-881-0765
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Fax | 216-431-2190
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Provider Business Mailing Address
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Address Line | 5209 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-3703
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Country | US
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Telephone | 216-881-0765
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Fax | 216-431-2190
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT J MOORE
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Credential |
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Telephone | 216-881-0765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D2027185
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License Number State | OH
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