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General NPI Number Information
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NPI Number | 1447764436
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Entity Type | Individual
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Provider Name | VIVIAN GARCIA
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Gender | Female
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Dates
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Enumeration Date | 11/29/2017
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Last Update Date | 11/29/2017
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Provider Practice Location Address
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Address Line | 3100 E 45TH ST STE 212
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City | CLEVELAND
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State | OH
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Zip | 44127-1093
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Country | US
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Telephone | 216-341-5510
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Fax |
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Provider Business Mailing Address
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Address Line | 1043 W 30TH ST
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City | LORAIN
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State | OH
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Zip | 44052-4660
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Country | US
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Telephone | 440-458-1858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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