Provider Demographics
NPI:1538119821
Name:AIDS TASKFORCE OF GREATER CLEVELAND, INC.
Entity Type:Organization
Organization Name:AIDS TASKFORCE OF GREATER CLEVELAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:FLICKINGER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:216-621-0766
Mailing Address - Street 1:3210 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-2510
Mailing Address - Country:US
Mailing Address - Phone:216-621-0766
Mailing Address - Fax:216-622-7788
Practice Address - Street 1:3210 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2510
Practice Address - Country:US
Practice Address - Phone:216-621-0766
Practice Address - Fax:216-622-7788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHN/A251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH12186Medicare UPIN