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NPI Code Detail

MEDICARE: ANOLA MACK

MEDICARE: ANOLA MACK
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
1104100000XSocial WorkerS.2613833OH

General Provider Information

NPI Number : 1992297345
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANOLA MACK
Provider Business Mailing Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number :
Provider Business Practice Location Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2018
Last Update Date : 05/28/2026

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Directions to “ ANOLA MACK ” Practice Location

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