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NPI Code Detail

MEDICARE: WEST SIDE ECUMENICAL MINISTRY

MEDICARE: WEST SIDE ECUMENICAL MINISTRY
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
1251B00000XCase Management Agency0505OH

General Provider Information

NPI Number : 1548272115
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST SIDE ECUMENICAL MINISTRY
Provider Business Mailing Address
First Line : 5209 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-2224
Country : US
Telephone Number : 216-651-2037
Fax Number : 216-651-4145
Provider Business Practice Location Address
First Line : 5209 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-2224
Country : US
Telephone Number : 216-651-2037
Fax Number : 216-651-4145
Authorized Official
Title or Position : PRESIDENT/CEO
Name : JUDITH PETERS
Credential : R.N.
Telephone Number : 216-651-2037
Provider Enumeration Date : 08/12/2006
Last Update Date : 08/22/2020

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Directions to “WEST SIDE ECUMENICAL MINISTRY ” 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.