Provider Demographics
NPI:1508198193
Name:CLEVELAND TEAM CONSTRUCTION
Entity Type:Organization
Organization Name:CLEVELAND TEAM CONSTRUCTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:PETERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-685-1595
Mailing Address - Street 1:1420 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-5231
Mailing Address - Country:US
Mailing Address - Phone:216-685-1595
Mailing Address - Fax:216-685-1605
Practice Address - Street 1:1420 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-5231
Practice Address - Country:US
Practice Address - Phone:216-685-1595
Practice Address - Fax:216-685-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care