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General NPI Number Information
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NPI Number | 1316629827
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Entity Type | Organization
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Legal Business Name | MCREYNOLDS COMMUNITY SERVICES
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 6014 ANDOVER BLVD STE 201
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125
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Country | US
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Telephone | 216-612-2592
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Fax |
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Provider Business Mailing Address
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Address Line | 815 SUPERIOR AVE E STE 1618
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City | CLEVELAND
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State | OH
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Zip | 44114-2709
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Country | US
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Telephone | 216-612-2592
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANGELA TAYLOR-MCREYNOLDS
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Credential |
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Telephone | 216-612-2592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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