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General NPI Number Information
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NPI Number | 1366987554
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTH INC.
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Dates
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Enumeration Date | 12/27/2016
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 38882 MENTOR AVE
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City | WILLOUGHBY
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State | OH
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Zip | 44094-7875
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Country | US
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Telephone | 440-953-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 38882 MENTOR AVE
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City | WILLOUGHBY
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State | OH
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Zip | 44094-7875
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN LEE
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Credential |
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Telephone | 440-953-9999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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