MEDICARE: JOY LYNN RIOS

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	175T00000X	Peer Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NONE

General Provider Information

NPI Number	:	1871175430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY LYNN RIOS

Provider Business Mailing Address
First Line	:	2012 W 25TH ST STE 716
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-4131
Country	:	US
Telephone Number	:	216-264-0841
Fax Number	:

Provider Business Practice Location Address
First Line	:	2012 W 25TH ST STE 716
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-4131
Country	:	US
Telephone Number	:	216-264-0841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	04/23/2021

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Directions to “ JOY LYNN RIOS ” Practice Location

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