Provider Demographics
NPI:1013534957
Name:CLEVELAND BEHAVIORAL HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:CLEVELAND BEHAVIORAL HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-821-0051
Mailing Address - Street 1:30628 DETROIT RD STE 125
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5844
Mailing Address - Country:US
Mailing Address - Phone:440-821-0051
Mailing Address - Fax:
Practice Address - Street 1:30628 DETROIT RD STE 125
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5844
Practice Address - Country:US
Practice Address - Phone:440-821-0051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty