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General NPI Number Information
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NPI Number | 1730847831
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Entity Type | Organization
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Legal Business Name | FAMILY PROMISE OF GREATER CLEVELAND
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 3470 E 152ND ST
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City | CLEVELAND
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State | OH
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Zip | 44120-4242
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Country | US
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Telephone | 216-767-4060
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Fax |
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Provider Business Mailing Address
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Address Line | 3470 E 152ND ST
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City | CLEVELAND
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State | OH
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Zip | 44120-4242
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Country | US
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Telephone | 216-767-4060
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JACQUELINE SUSAN SALTER
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Credential | PCC-S, LMFT
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Telephone | 216-767-4061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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