Provider Demographics
NPI:1477363679
Name:CLEVELAND EMBODIMENT COLLECTIVE, LLC
Entity type:Organization
Organization Name:CLEVELAND EMBODIMENT COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:216-243-1404
Mailing Address - Street 1:2358 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-3678
Mailing Address - Country:US
Mailing Address - Phone:216-243-1404
Mailing Address - Fax:
Practice Address - Street 1:2358 W 11TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3678
Practice Address - Country:US
Practice Address - Phone:216-243-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty