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NPI Code Detail

MEDICARE: KC CENTER FOR HEALTH AND WELLNESS, LLC

MEDICARE: KC CENTER FOR HEALTH AND WELLNESS, LLC
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2385H00000XRespite Care
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1346883717
Entity Type Code : Organization
Provider Name (Legal Business Name) : KC CENTER FOR HEALTH AND WELLNESS, LLC
Provider Business Mailing Address
First Line : 3793 GREEN RD
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5705
Country : US
Telephone Number : 216-232-5302
Fax Number : 216-393-3690
Provider Business Practice Location Address
First Line : 3793 GREEN RD
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5705
Country : US
Telephone Number : 216-232-5302
Fax Number : 216-393-3690
Authorized Official
Title or Position : CEO
Name : ASHLEY KING
Credential : NP-C
Telephone Number : 216-232-5302
Provider Enumeration Date : 10/18/2019
Last Update Date : 05/18/2026

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Directions to “KC CENTER FOR HEALTH AND WELLNESS, LLC ” Practice Location

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