EAST SIDE CATHOLIC CENTER & SHELTER (NPI# 1346331501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346331501 |
| Entity Type | Organization |
| Organization Name | EAST SIDE CATHOLIC CENTER & SHELTER |
| Other Organization Name | MIRACLE VILLAGE |
| Practice Address |
4500 Kennard Ct Cleveland OH 44104-1321 |
| Mailing Address |
Po Box 20177 Cleveland OH 44120-0177 |
| Practice Telephone | 2162315556 |
| Practice Fax Number | 2162313993 |
| Mailing Telephone | 2162315556 |
| Mailing Fax Number | 2162313993 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MICHELLE BURLEY-KEYS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2162315556 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Miracle Village | Other Name - Individual/Organization |
| Street Address |
4500 KENNARD CT |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44104-1321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619510419 | Gwen Burtin | Technician | 9908 Kennedy Ave, Cleveland, OH 44104 | 2019-10-24 |
| 1215422001 | Julia Shneyderman | Dentist | 11202 Shaker Blvd Ste 136, Cleveland, OH 44104 | 2018-06-25 |
| 1477058527 | Kwananda A Plato | Technician | 9717 Elwell Ave., Cleveland, OH 44104 | 2018-03-29 |
| 1073035887 | Tia Marie Heard | Home Health | 4591 Quincy Avenue Building Q, Cleveland, OH 44104 | 2017-07-13 |
| 1407306608 | Shelby Mcquiller | Social Worker | 2632 E 115th St, Cleveland, OH 44104 | 2016-10-11 |
| 1568852390 | Cleveland Arts & Social Sciences Academy | Psychologist | 10701 Shaker Blvd, Cleveland, OH 44104 | 2015-02-02 |
| 1164827705 | Eboni Danyale Jordan | Licensed Practical Nurse | 3143 East 99th, Cleveland, OH 44104 | 2014-10-24 |
| 1902224157 | Woodland Academy, Inc. | Local Education Agency (LEA) | 10615 Lamontier Blvd., Cleveland, OH 44104 | 2014-04-04 |
| 1467793778 | Teresa M Evans-guyton | Nurse Practitioner | 11201 Shaker Blvd Ste 240, Cleveland, OH 44104 | 2013-03-12 |
| 1023387057 | Roslyn Jeanette Carter | Home Health Aide | 9423 Ramona Blvd, Cleveland, OH 44104 | 2011-12-20 |
| Find all providers in zip 44104 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447728902 | Miklat Recovery | Substance Abuse Rehabilitation Facility | 2490 Lee Blvd Ste 319, Cleveland, OH 44118-1271 | 2018-11-02 |
| 1790095297 | A New Beginning Sober Living | Substance Abuse Rehabilitation Facility | 11402 Avon Ave, Cleveland, OH 44105-4304 | 2010-10-18 |
| 1497871719 | Community Assessment and Treatment Services, Inc | Substance Abuse Rehabilitation Facility | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2007-03-21 |
| 1477623981 | Fresh Start, Inc. | Substance Abuse Rehabilitation Facility | 4807 Cedar Ave, Cleveland, OH 44103-4437 | 2006-11-09 |
| 1851470603 | Orca House | Substance Abuse Rehabilitation Facility | 1909 E 89th St, Cleveland, OH 44106-2007 | 2006-11-03 |
| 1407931314 | Orca House, Inc | Substance Abuse Rehabilitation Facility | 1914 E 90th St, Cleveland, OH 44106-2082 | 2006-10-26 |
| 1144302795 | Orca House, Inc. | Substance Abuse Rehabilitation Facility | 1905 E 89th St, Cleveland, OH 44106-2007 | 2006-10-20 |
| 1740373992 | Eastside Catholic Center & Shelter | Substance Abuse Rehabilitation Facility | 13211 Chapelside Ave, Cleveland, OH 44120-4605 | 2006-10-02 |
| 1447342696 | Hispanic Urban Minority Alcoholism and Drug Abuse Outreach Program, In | Substance Abuse Rehabilitation Facility | 2202 Prame Avenue, Cleveland, OH 44109-1613 | 2006-09-28 |
| 1104927417 | Eastside Catholic Center & Shelter | Substance Abuse Rehabilitation Facility | 11701 Shaker Blvd, Cleveland, OH 44120-1956 | 2006-09-26 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.