MEDICARE: WASHINGTON HEALTH CARE MANAGEMENT, 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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1356868871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON HEALTH CARE MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	11510 BUCKEYE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3828
Country	:	US
Telephone Number	:	216-721-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	11510 BUCKEYE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3828
Country	:	US
Telephone Number	:	216-721-7700
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. JOSEPH GREGORY PEPOY
Credential	:
Telephone Number	:	216-272-1034

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	07/21/2022

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