Provider Demographics
NPI:1104398312
Name:GLOVAN POLLAK AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:GLOVAN POLLAK AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-392-2222
Mailing Address - Street 1:8224 MENTOR AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5743
Mailing Address - Country:US
Mailing Address - Phone:440-392-2222
Mailing Address - Fax:440-565-2349
Practice Address - Street 1:8224 MENTOR AVE STE 208
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5743
Practice Address - Country:US
Practice Address - Phone:440-392-2222
Practice Address - Fax:440-565-2349
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLOVAN POLLAK AND ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)