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General NPI Number Information
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NPI Number | 1750279162
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Entity Type | Organization
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Legal Business Name | EDENIC HEALTH LLC
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1200 BRENTWOOD RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44121-1538
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Country | US
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Telephone | 313-408-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BRENTWOOD RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44121-1538
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AHRAYA POLLARD
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Credential |
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Telephone | 313-408-5448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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