NPI:
1861165813
Provider Name:
20611 EUCLID OPERATING CO., LLC
Doing Business As: ETHAN CROSSING OF CLEVELAND
Classification:
Clinic/Center - 261QR0405X
Entity Type:
Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 36D2231369
Address:
20611 EUCLID AVE
EUCLID, OH
ZIP 44117
Phone:
(216) 859-2727
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20611 EUCLID OPERATING CO., LLC is a rehabilitation and substance use disorder clinic center in Euclid, OH. 20611 EUCLID OPERATING CO., LLC NPI is 1861165813. The provider is registered as an organization entity type.
The provider Is Doing Business As Ethan Crossing Of Cleveland.
The provider's business location address is:
20611 EUCLID AVE
EUCLID, OH
ZIP 44117-521
Phone: (216) 859-2727
The provider's authorized official is Isaac Rosedale .
The authorized official title is President and has the following contact phone number (513) 489-7100.
The CLIA number assigned to this NPI record is 36D2231369 - other - residential treatment with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/27/2021 and was last updated on 8/27/2021.