| Dr. Manuel E. Gordillo Inc. | |
|
30400 Detroit Rd Suite 304 Westlake OH 44145-1872 | |
| (440) 835-6189 | |
| (440) 899-4357 |
| Full Name | Dr. Manuel E. Gordillo Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 30400 Detroit Rd, Westlake, Ohio |
| Authorized Official Name and Position | Manuel E. Gordillo (PRESIDENT) |
| Authorized Official Contact | 4408356189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Manuel E. Gordillo Inc. 30400 Detroit Rd Suite 304 Westlake OH 44145-1872 Ph: (440) 835-6189 | Dr. Manuel E. Gordillo Inc. 30400 Detroit Rd Suite 304 Westlake OH 44145-1872 Ph: (440) 835-6189 |
| NPI Number | 1801053111 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801053111 | NPI | - | NPPES |
| 000000126508 | Other | ANTHEM ID | |
| 0123780 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 028854 (Ohio) | Primary |
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