Provider Demographics
NPI:1528410529
Name:SAFY OF CLEVELAND
Entity Type:Organization
Organization Name:SAFY OF CLEVELAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERVENTION SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:IRVIN
Authorized Official - Middle Name:V
Authorized Official - Last Name:GASTON
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:216-295-7239
Mailing Address - Street 1:20600 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5327
Mailing Address - Country:US
Mailing Address - Phone:216-295-7239
Mailing Address - Fax:
Practice Address - Street 1:20600 CHAGRIN BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5327
Practice Address - Country:US
Practice Address - Phone:216-295-7239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0025611253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency