Provider Demographics
NPI:1073758082
Name:UNIVERSAL MEDICAL ADMINISTRATION, LLC
Entity Type:Organization
Organization Name:UNIVERSAL MEDICAL ADMINISTRATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CASTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-243-5914
Mailing Address - Street 1:7055 ENGLE RD
Mailing Address - Street 2:404
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44130-8491
Mailing Address - Country:US
Mailing Address - Phone:440-243-5914
Mailing Address - Fax:440-243-6530
Practice Address - Street 1:7055 ENGLE RD
Practice Address - Street 2:404
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44130-8491
Practice Address - Country:US
Practice Address - Phone:440-243-5914
Practice Address - Fax:440-243-6530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3504103T00000X
OH4068103T00000X
OH3565103T00000X
OH4072103T00000X
OH6096103T00000X
OH1543103T00000X
OH2711103T00000X
OH4553103T00000X
OH3017103T00000X
OH5941103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty