Jordan Community Residential Center
NPI #1164068524 in Willoughby, Ohio
Provider Information
- NPI Number
- 1164068524
- Entity Type
- Organization
- Organization Name
- Jordan Community Residential Center
- Primary Specialty
- Psychologist - Addiction (Substance Use Disorder)
- Enumeration Date
- Nov 20, 2019
- Last Updated
- Feb 4, 2025
Practice Location
- Address
- 30841 EUCLID AVE STE 103
- City
- Willoughby
- State
- Ohio
- ZIP Code
- 44094-3100
- Phone
- (216) 441-2496
Authorized Official
- Name
- MS. TENISHA GANT
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (216) 441-2496
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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