Jordan Community Residential
NPI #1467098822 in Willoughby, Ohio
Provider Information
- NPI Number
- 1467098822
- Entity Type
- Organization
- Organization Name
- Jordan Community Residential
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Nov 20, 2019
- Last Updated
- Apr 26, 2024
Practice Location
- Address
- 30841 EUCLID AVE STE 103
- City
- Willoughby
- State
- Ohio
- ZIP Code
- 44094-3100
- Phone
- (216) 441-2496
Authorized Official
- Name
- TENISHA GANT
- Title
- CHIEF EXECUTIVE OFFICER
- Phone
- (216) 441-2496
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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