NPIMap

Organization Active NPI

East Side Catholic Center & Shelter

  • Substance Abuse Rehabilitation Facility
  • Cleveland, OH
National Provider Identifier
1346331501
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EAST SIDE CATHOLIC CENTER & SHELTER
Practice address
4500 Kennard CT
Cleveland, OH 44104-1321
Phone
(216) 231-5556
Fax
(216) 231-3993
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Michelle Burley-Keys
Title
Executive Director
Phone
(216) 231-5556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

4500 Kennard CT
Cleveland, OH 44104-1321

Mailing address

PO Box 20177
Cleveland, OH 44120-0177
Phone (216) 231-5556

Other names 1

  • Miracle Village Other name

National Provider Directory

National Provider Directory
Tax ID family
Eastside Catholic Center Shelter3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346331501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20177",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441200177",
            "telephone_number": "216-231-5556",
            "fax_number": "216-231-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 KENNARD CT",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441041321",
            "telephone_number": "216-231-5556",
            "fax_number": "216-231-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SIDE CATHOLIC CENTER & SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURLEY-KEYS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "216-231-5556",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.