Provider Demographics
NPI:1144572777
Name:CLEVELAND RAPE CRISIS CENTER
Entity Type:Organization
Organization Name:CLEVELAND RAPE CRISIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF CLIENT & CLINICAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIRSTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNCEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S, LCDCIII
Authorized Official - Phone:216-619-6194
Mailing Address - Street 1:526 SUPERIOR AVE E
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1902
Mailing Address - Country:US
Mailing Address - Phone:216-619-6194
Mailing Address - Fax:216-619-6195
Practice Address - Street 1:526 SUPERIOR AVE E
Practice Address - Street 2:SUITE 1400
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1902
Practice Address - Country:US
Practice Address - Phone:216-619-6194
Practice Address - Fax:216-619-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0700212251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health