Basic Information
| Provider Information | |||||||||
| NPI: | 1790884716 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAILY BEHAVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14538 GRAPELAND AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441112107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162521399 | ||||||||
| FaxNumber: | 2162521409 | ||||||||
| Practice Location | |||||||||
| Address1: | 14538 GRAPELAND AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441112107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162521399 | ||||||||
| FaxNumber: | 2162521409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 01/11/2011 | ||||||||
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| AuthorizedOfficialLastName: | DAILY | ||||||||
| AuthorizedOfficialFirstName: | CARA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2162521399 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.