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NPI Code Detail

MEDICARE: STEADFAST HEALTH PROFESSIONAL SERVICES OF OHIO INC

MEDICARE: STEADFAST HEALTH PROFESSIONAL SERVICES OF OHIO 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
1101YM0800XMental Health Counselor
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
3261QM1300XMulti-Specialty Clinic/Center
4251S00000XCommunity/Behavioral Health Agency
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
6101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1457201956
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEADFAST HEALTH PROFESSIONAL SERVICES OF OHIO INC
Provider Business Mailing Address
First Line : 11201 SHAKER BLVD STE 106
Second Line :
City : CLEVELAND
State : OH
Zip : 44104-3833
Country : US
Telephone Number : 866-935-0936
Fax Number :
Provider Business Practice Location Address
First Line : 11201 SHAKER BLVD STE 106
Second Line :
City : CLEVELAND
State : OH
Zip : 44104-3833
Country : US
Telephone Number : 866-935-0936
Fax Number :
Authorized Official
Title or Position : COO
Name : DAVIS STEPHEN
Credential : MD
Telephone Number : 615-987-5512
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “STEADFAST HEALTH PROFESSIONAL SERVICES OF OHIO INC ” Practice Location

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