Provider Demographics
NPI:1326105750
Name:EMERALD DEVELOPMENT AND ECONOMIC NETWORK, INC
Entity Type:Organization
Organization Name:EMERALD DEVELOPMENT AND ECONOMIC NETWORK, INC
Other - Org Name:EDEN, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-961-9690
Mailing Address - Street 1:7812 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-4056
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7812 MADISON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-4056
Practice Address - Country:US
Practice Address - Phone:216-961-9690
Practice Address - Fax:216-651-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
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)