Provider Demographics
NPI:1275588808
Name:NEIGHBORING
Entity Type:Organization
Organization Name:NEIGHBORING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:W
Authorized Official - Middle Name:SPENCE
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:III
Authorized Official - Credentials:JD MED LPC
Authorized Official - Phone:440-354-9924
Mailing Address - Street 1:5930 HEISLEY RD
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1834
Mailing Address - Country:US
Mailing Address - Phone:440-354-9924
Mailing Address - Fax:
Practice Address - Street 1:5930 HEISLEY RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-1834
Practice Address - Country:US
Practice Address - Phone:440-354-9924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2362429Medicaid
9282481Medicare ID - Type Unspecified
OH2362429Medicaid