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General NPI Number Information
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NPI Number | 1417662305
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Entity Type | Organization
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Legal Business Name | YOUR PRECIOUS DREAMS, LLC
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Dates
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Enumeration Date | 01/16/2023
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 1001 LAKESIDE AVE E
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City | CLEVELAND
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State | OH
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Zip | 44114-1158
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Country | US
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Telephone | 216-867-7930
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Fax | 216-250-8209
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Provider Business Mailing Address
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Address Line | 2532 E 86TH ST
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City | CLEVELAND
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State | OH
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Zip | 44104-2244
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Country | US
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Telephone | 216-867-7930
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Fax | 216-250-8209
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Authorized Official
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Title or Position | OWNER
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Name | DEBRA L MARTIN
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Credential |
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Telephone | 216-867-7930
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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