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General NPI Number Information
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NPI Number | 1801458799
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Entity Type | Organization
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Legal Business Name | TRULY TRANSFORMED, LLC
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 17325 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44112-1247
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Country | US
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Telephone | 216-905-4439
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Fax |
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Provider Business Mailing Address
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Address Line | 541 CORKHILL RD APT 199
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City | BEDFORD
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State | OH
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Zip | 44146-3467
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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 | OWNER
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Name | MONICA WRIGHT
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Credential |
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Telephone | 216-905-4439
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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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