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Cuyahoga County BD of MRDD

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Cleveland, OH

NPI 1407060684 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1407060684
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
1815533 (OH)
Legal business name
CUYAHOGA COUNTY BD OF MRDD
Practice address
1905 Green Rd
Cleveland, OH 44112-1021
Phone
(216) 736-2526
Fax
(216) 736-2702
NPI assigned
May 9, 2007
Organization subpart
No

Authorized official

Name
Mr. Terrence Ryan
Title
Superintendent
Phone
(216) 736-2625

Corporate family (same tax ID) 46

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

View all 46

National Provider Directory

Tax ID family
County of Cuyahoga (47 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 1815533 OH Yes

Addresses

Primary practice location

1905 Green Rd
Cleveland, OH 44112-1021

Mailing address

1275 Lakeside Ave E
Cleveland, OH 44114-1132
Phone (216) 736-2625

Other identifiers

IdentifierTypeStateIssuer
2538525MedicaidOH

Other names

  • Green House Doing business as

Other providers in Cleveland, OH

All providers in Cleveland, OH · Intellectual Disabilities Intermediate Care Facility in Ohio

Sources for this page

Verify at the official NPI Registry.