Provider Demographics
NPI:1184194045
Name:NEAR WEST SIDE MULTI SERVICE CORPORATION
Entity Type:Organization
Organization Name:NEAR WEST SIDE MULTI SERVICE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:KEMM
Authorized Official - Suffix:
Authorized Official - Credentials:MNO
Authorized Official - Phone:216-631-5800
Mailing Address - Street 1:4115 BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3304
Mailing Address - Country:US
Mailing Address - Phone:216-631-5800
Mailing Address - Fax:216-631-4595
Practice Address - Street 1:4115 BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3304
Practice Address - Country:US
Practice Address - Phone:216-631-5800
Practice Address - Fax:216-631-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management