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General NPI Number Information
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NPI Number | 1740892256
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Entity Type | Organization
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Legal Business Name | AHAVA CENTER FOR HEALTH AND WELLNESS
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 2101 RICHMOND RD STE 1005
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City | BEACHWOOD
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State | OH
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Zip | 44122-1390
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Country | US
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Telephone | 216-208-7930
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Fax |
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Provider Business Mailing Address
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Address Line | 22891 ARMS AVE
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City | EUCLID
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State | OH
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Zip | 44123-3217
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Country | US
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Telephone | 216-208-7930
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY GULLEY
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Credential | LISW
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Telephone | 216-208-7930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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