Provider Demographics
NPI:1386897189
Name:LESBIAN, GAY, BISEXUAL & TRANSGENDER COMMUNITY CENTER OF GREATER CLEVE
Entity type:Organization
Organization Name:LESBIAN, GAY, BISEXUAL & TRANSGENDER COMMUNITY CENTER OF GREATER CLEVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOERFER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-651-5428
Mailing Address - Street 1:6600 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3016
Mailing Address - Country:US
Mailing Address - Phone:216-651-5428
Mailing Address - Fax:216-651-6439
Practice Address - Street 1:6600 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3016
Practice Address - Country:US
Practice Address - Phone:216-651-5428
Practice Address - Fax:216-651-6439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00094231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty