Provider Demographics
NPI:1619932555
Name:CLEVELAND URBAN MINORITY ALCOHOLISM & DRUG ABUSE OUTREACH PROJECT, INC
Entity Type:Organization
Organization Name:CLEVELAND URBAN MINORITY ALCOHOLISM & DRUG ABUSE OUTREACH PROJECT, INC
Other - Org Name:CLEVELAND UMADAOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HUMAN RESOURCE DIRECTOR/MIS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORSON-EADDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-361-2040
Mailing Address - Street 1:1215 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2255
Mailing Address - Country:US
Mailing Address - Phone:216-361-2040
Mailing Address - Fax:216-361-1856
Practice Address - Street 1:1215 E 79TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-2255
Practice Address - Country:US
Practice Address - Phone:216-361-2040
Practice Address - Fax:216-361-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01174Medicare UPIN