Provider Demographics
NPI:1720762644
Name:PERKINS, DESEAN LEMAR
Entity type:Individual
Prefix:
First Name:DESEAN
Middle Name:LEMAR
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17325 EUCLID AVE STE 3144
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-1256
Mailing Address - Country:US
Mailing Address - Phone:216-355-9812
Mailing Address - Fax:
Practice Address - Street 1:17325 EUCLID AVE STE 3144
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-1256
Practice Address - Country:US
Practice Address - Phone:216-355-9812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator