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NPI Code Detail

MEDICARE: LEE HARVARD TREATMENT INC

MEDICARE: LEE HARVARD TREATMENT INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center35059795OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
328658600300OTHEROHOBWC

General Provider Information

NPI Number : 1255539631
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEE HARVARD TREATMENT INC
Provider Business Mailing Address
First Line : 16603 HARVARD AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-2203
Country : US
Telephone Number : 216-921-5222
Fax Number : 216-921-6421
Provider Business Practice Location Address
First Line : 16603 HARVARD AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-2203
Country : US
Telephone Number : 216-921-5222
Fax Number : 216-921-6421
Authorized Official
Title or Position : PHYSICIAN
Name : MARCELLUS GILREATH
Credential : MD
Telephone Number : 216-921-5222
Provider Enumeration Date : 07/06/2007
Last Update Date : 09/26/2008

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Directions to “LEE HARVARD TREATMENT INC ” Practice Location

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