MEDICARE: CARE ALLIANCE

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	207QA0000X	Adolescent Medicine (Family Medicine) Physician

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	:	1528520533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE ALLIANCE

Provider Business Mailing Address
First Line	:	1530 SAINT CLAIR AVE NE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-2004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2439 E 55TH ST FL 2
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44104-1501
Country	:	US
Telephone Number	:	216-535-9100
Fax Number	:	216-298-5015

Authorized Official
Title or Position	:	REVENUE CYCLE MANAGER
Name	:	YULANDA K LEE
Credential	:
Telephone Number	:	216-535-9100

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	04/01/2019

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Directions to “CARE ALLIANCE ” Practice Location

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