Provider Demographics
NPI:1285417618
Name:CLEVELAND COUPLES CENTER
Entity type:Organization
Organization Name:CLEVELAND COUPLES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:440-646-8259
Mailing Address - Street 1:12417 CEDAR RD STE 23
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3157
Mailing Address - Country:US
Mailing Address - Phone:216-798-2669
Mailing Address - Fax:
Practice Address - Street 1:12417 CEDAR RD STE 23
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44106-3157
Practice Address - Country:US
Practice Address - Phone:216-798-2669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty