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General NPI Number Information
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NPI Number | 1659839041
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Entity Type | Organization
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Legal Business Name | LUTHERAN METROPOLITAN MINISTRY
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 4100 FRANKLIN BLVD
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City | CLEVELAND
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State | OH
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Zip | 44113-2842
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Country | US
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Telephone | 216-281-2500
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Fax | 216-281-2500
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Provider Business Mailing Address
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Address Line | 4515 SUPERIOR AVE
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City | CLEVELAND
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State | OH
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Zip | 44103-1215
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Country | US
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Telephone | 216-623-0959
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Fax | 216-281-2506
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Authorized Official
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Title or Position | VP, HWS
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Name | LISA SMITH
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Credential | LICDC
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Telephone | 216-281-2500
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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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