MEDICARE: CENTER FOR INTEGRATED THERAPIES

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	261QH0100X	Health Service Clinic/Center	35 064851	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	:	1912195827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR INTEGRATED THERAPIES

Provider Business Mailing Address
First Line	:	11002 DETROIT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-2413
Country	:	US
Telephone Number	:	216-227-8668
Fax Number	:	216-227-9821

Provider Business Practice Location Address
First Line	:	11002 DETROIT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-2413
Country	:	US
Telephone Number	:	216-227-8668
Fax Number	:	216-227-9821

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HARRY D SIMMONS
Credential	:	MD, PHD
Telephone Number	:	216-227-8668

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	10/05/2007

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