Provider Demographics
NPI:1740892256
Name:AHAVA CENTER FOR HEALTH AND WELLNESS
Entity type:Organization
Organization Name:AHAVA CENTER FOR HEALTH AND WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GULLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-208-7930
Mailing Address - Street 1:22891 ARMS AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-3217
Mailing Address - Country:US
Mailing Address - Phone:216-208-7930
Mailing Address - Fax:
Practice Address - Street 1:2101 RICHMOND RD STE 1005
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1390
Practice Address - Country:US
Practice Address - Phone:216-208-7930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty