SHAKER HEIGHTS YOUTH CENTER NPI 1851355960

NPI Information

NPI: 1851355960
Provider Name: SHAKER HEIGHTS YOUTH CENTER
Classification: Voluntary or Charitable - 251V00000X
Entity Type: Organization

CLIA Number: 36D0679206

Address:
17300 VAN AKEN BLVD
SHAKER HEIGHTS, OH
ZIP 44120
Phone: (216) 752-9292
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SHAKER HEIGHTS YOUTH CENTER is a voluntary or charitable in Shaker Heights, OH. SHAKER HEIGHTS YOUTH CENTER NPI is 1851355960. The provider is registered as an organization entity type.

The provider's business location address is:

17300 VAN AKEN BLVD
SHAKER HEIGHTS, OH
ZIP 44120-460
Phone: (216) 752-9292
Fax: (216) 752-7217

The provider's authorized official is John James Lisy .
The authorized official title is Executive Director and has the following contact phone number (216) 752-9292.

The CLIA number assigned to this NPI record is 36D0679206 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/14/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251V00000X	Voluntary or Charitable		N/A		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01081	OTHER	OHIO	ODADAS UPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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