Provider Demographics
NPI:1710240981
Name:CITY OF CLEVELAND
Entity Type:Organization
Organization Name:CITY OF CLEVELAND
Other - Org Name:CLEVELAND DEPARTMENT OF PUBLIC HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, DEPARTMENT OF HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:216-664-7414
Mailing Address - Street 1:75 ERIEVIEW PLZ
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1839
Mailing Address - Country:US
Mailing Address - Phone:216-664-2000
Mailing Address - Fax:216-420-7741
Practice Address - Street 1:11100 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-1943
Practice Address - Country:US
Practice Address - Phone:216-664-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1073251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2916750Medicaid
OH1073OtherODADAS PROVIDER NUMBER