| Proud To Be, Inc | |
|
11811 Shaker Blvd Ste 123 Cleveland OH 44120-1927 | |
| (216) 242-2990 | |
| Not Available |
| Full Name | Proud To Be, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11811 Shaker Blvd Ste 123, Cleveland, Ohio |
| Authorized Official Name and Position | Lisa Sullivan (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4404530754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proud To Be, Inc 11811 Shaker Blvd Ste 123 Cleveland OH 44120-1927 Ph: () - | Proud To Be, Inc 11811 Shaker Blvd Ste 123 Cleveland OH 44120-1927 Ph: (216) 242-2990 |
| NPI Number | 1629840707 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629840707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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