| Gordon Square Health Center | |
|
6705 Detroit Ave Cleveland OH 44102-3017 | |
| (216) 957-4905 | |
| Not Available |
| Full Name | Gordon Square Health Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 6705 Detroit Ave, Cleveland, Ohio |
| Authorized Official Name and Position | Derrick Hollings (EVP/CFO) |
| Authorized Official Contact | 2167787800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Square Health Center 6705 Detroit Ave Cleveland OH 44102-3017 Ph: (216) 957-4905 | Gordon Square Health Center 6705 Detroit Ave Cleveland OH 44102-3017 Ph: (216) 957-4905 |
| NPI Number | 1700639358 |
|---|---|
| Provider Enumeration Date | 04/11/2024 |
| Last Update Date | 05/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700639358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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