MEDICARE: CUYAHOGA COUNTY BD. OF MRDD

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	315P00000X	Intellectual Disabilities Intermediate Care Facility	1813416	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1457566168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUYAHOGA COUNTY BD. OF MRDD

Provider Business Mailing Address
First Line	:	1275 LAKESIDE AVE E
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-1132
Country	:	US
Telephone Number	:	216-736-2625
Fax Number	:	216-736-2702

Provider Business Practice Location Address
First Line	:	211 E SCHAAF RD
Second Line	:
City	:	BROOKLYN HTS
State	:	OH
Zip	:	44131-1204
Country	:	US
Telephone Number	:	216-736-2625
Fax Number	:	216-736-2702

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. TERRENCE RYAN
Credential	:
Telephone Number	:	216-736-2625

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1740292838 — DR. JOSEPH P. LALKA MD
Practice Location Address:

159 JEFFERSON HTS, GMA SUITE A102 , CATSKILL VA PRIMARY CARE
CATSKILL, NY
12414-1204

Practice Phone: 518-626-5240
Practice Fax: 518-943-7289

1487184735 — MARIA AMIRA COVINGTON M.D.
Practice Location Address:

159 JEFFERSON HTS STE C103
CATSKILL, NY
12414-1204

Practice Phone: 518-943-2557
Practice Fax: 518-943-2739

1528612892 — MEGHAN B ROTHROCK
Practice Location Address:

159 JEFFERSON HTS STE C103
CATSKILL, NY
12414-1204

Practice Phone: 518-943-2557
Practice Fax:

1497426068 — DR. ARIANA ELIZABETH GARAFALO PHARMD
Practice Location Address:

159 JEFFERSON HTS STE D102
CATSKILL, NY
12414-1204

Practice Phone: 518-943-1715
Practice Fax:

1326056631 — MRS. ELIZABETH ANN BAISHNAB RPH
Practice Location Address:

5420 LANCASTER DR
BROOKLYN HTS, OH
44131-1832

Practice Phone: 216-676-6099
Practice Fax:

1548363757 — KAISER PERMANENTE
Practice Location Address:

5410 LANCASTER DR
BROOKLYN HTS, OH
44131

Practice Phone: 216-265-8810
Practice Fax: 216-265-8890

Directions to “CUYAHOGA COUNTY BD. OF MRDD ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.