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General NPI Number Information
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NPI Number | 1689715047
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Entity Type | Organization
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Legal Business Name | CLEVELAND COMMUNITY & HOME SUPPORT SERVICES INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 222 N LAFAYETTE ST STE 2
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City | SHELBY
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State | NC
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Zip | 28150-4450
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Country | US
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Telephone | 704-471-9755
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Fax | 704-480-7040
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Provider Business Mailing Address
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Address Line | 222 N LAFAYETTE ST STE 2
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City | SHELBY
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State | NC
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Zip | 28150-4450
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Country | US
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Telephone | 704-471-9755
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Fax | 704-480-7040
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MS. DAWN EARWOOD BECK
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Credential | QDDP QMHP
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Telephone | 704-471-9755
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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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