Provider Demographics
NPI:1568014173
Name:NEIGHBORHOOD HEALTH CARE INCORPORATED
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTH CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-281-8945
Mailing Address - Street 1:4115 BRIDGE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3304
Mailing Address - Country:US
Mailing Address - Phone:216-281-8945
Mailing Address - Fax:216-961-5429
Practice Address - Street 1:3545 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-5464
Practice Address - Country:US
Practice Address - Phone:216-281-8945
Practice Address - Fax:216-961-5429
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEIGHBORHOOD HEALTH CARE INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-13
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0453076Medicaid