Provider Demographics
NPI:1497884175
Name:EL CENTRO DE SERVICIOS SOCIALES, INC.
Entity Type:Organization
Organization Name:EL CENTRO DE SERVICIOS SOCIALES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LEANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-277-8235
Mailing Address - Street 1:1888 E. 31ST. STREET
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055
Mailing Address - Country:US
Mailing Address - Phone:440-277-8235
Mailing Address - Fax:440-277-9236
Practice Address - Street 1:1888 E 31ST ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1810
Practice Address - Country:US
Practice Address - Phone:440-277-8235
Practice Address - Fax:440-277-9236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0039251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10112Medicare UPIN