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NPI Code Detail

MEDICARE: UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, INC.

MEDICARE: UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, 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
1235Z00000XSpeech-Language Pathologist
2251V00000XVoluntary or Charitable Agency
3261QA0600XAdult Day Care Clinic/Center
4261QP2000XPhysical Therapy Clinic/Center
5261QX0100XOccupational Medicine Clinic/Center
6320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility
7251C00000XDevelopmentally Disabled Services Day Training Agency
8261QD1600XDevelopmental Disabilities Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11800224OTHEROHI/O WAIVER AND CAFS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700880325
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNITED CEREBRAL PALSY ASSOCIATION OF GREATER CLEVELAND, INC.
Provider Business Mailing Address
First Line : 10011 EUCLID AVENUE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-4701
Country : US
Telephone Number : 216-791-8363
Fax Number : 216-721-3372
Provider Business Practice Location Address
First Line : 10011 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-4701
Country : US
Telephone Number : 216-791-8363
Fax Number : 216-721-3372
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. PATRICIA S. OTTER
Credential :
Telephone Number : 216-791-8363
Provider Enumeration Date : 06/10/2005
Last Update Date : 10/01/2013

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