MAGNOLIA CLUBHOUSE INC (NPI# 1902139033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902139033 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA CLUBHOUSE INC |
| Practice Address |
11101 Magnolia Dr Cleveland OH 44106-1813 |
| Practice Telephone | 2167213030 |
| Practice Fax Number | 2167210105 |
| Mailing Telephone | 2167213030 |
| Mailing Fax Number | 2167210105 |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | DR. LORI D'ANGELO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2167213030 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAGNOLIA CLUBHOUSE INCORPORATED | 11101 Magnolia Dr, Cleveland, OH 44106-1813 |
| Street Address |
11101 MAGNOLIA DR |
| City | CLEVELAND |
| State | OH |
| Zip Code | 44106-1813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164067427 | Nicholas Albino | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-11-11 |
| 1932740180 | Toni Hughes | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-09-30 |
| 1699325217 | Devin Heckler | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-09-16 |
| 1144879263 | Rachel Eden | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-09-11 |
| 1548825235 | Nicola Potts | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-05-08 |
| 1184186546 | John E Fisher | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2019-04-04 |
| 1285101733 | Debra Sue Bruss | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2018-11-01 |
| 1437633120 | Heather Shorten | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2018-09-19 |
| 1881178481 | Rebecca Lynn Sweinhart | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2018-09-19 |
| 1013490788 | Jingtian Wang | Social Worker | 11101 Magnolia Dr, Cleveland, OH 44106-1813 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347706 | Adeeb Oweidat | Anesthesiology | 1999 Circle Drive Centric, Apartment 417, Cleveland, OH 44106 | 2020-08-18 |
| 1104434240 | Bradly Miner | Student in an Organized Health Care Education/Training Program | Health Education Campus, 9501 Euclid Ave, Cleveland, OH 44106 | 2020-07-15 |
| 1306466974 | Ho Jun Lee | Student in an Organized Health Care Education/Training Program | 11100 Euclid Ave University Hospitals Cleveland Medical, Cleveland, OH 44106 | 2020-04-23 |
| 1528687837 | Shaleeka Cornelius | Student in an Organized Health Care Education/Training Program | 11100 Euclid Avenue Han 5042, University Hospitals Cleveland Medical Center, Cleveland, OH 44106 | 2020-04-16 |
| 1598393175 | Mikdat Ulas | Student in an Organized Health Care Education/Training Program | 111000 Euclid Avenue, Cleveland, OH 44106 | 2020-03-30 |
| 1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
| 1881246783 | Oziel Valdez Sanchez | Student in an Organized Health Care Education/Training Program | 11900 Euclid Ave, Cleveland, OH 44106 | 2019-07-10 |
| 1487216842 | Betina Griens Porto | Dentist | 9601 Chester Avenue, Case Western Reserve School of Dental Medicine, Cleveland, OH 44106 | 2019-07-05 |
| 1407417140 | Rebecca Petts | Dentist | 9601 Chester Ave, Cleveland, OH 44106 | 2019-06-24 |
| 1023677259 | Moeen Al Weshah | Student in an Organized Health Care Education/Training Program | 9601 Chester Ave # 239j3, Cleveland, OH 44106 | 2019-06-11 |
| Find all providers in zip 44106 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1386189967 | Frontline Services | Clinic/Center | 1744 Payne Avenue, Cleveland, OH 44114 | 2017-01-05 |
| 1174066096 | Thrive Behavioral Health Center Inc | Clinic/Center | 600 Superior Ave E Ste 1300, Cleveland, OH 44114-2654 | 2016-11-25 |
| 1417373705 | The Centers for Families and Children | Clinic/Center | 4400 Euclid Ave, Cleveland, OH 44103-3734 | 2014-03-11 |
| 1366708638 | Stella Maris, Inc. | Clinic/Center | 1320 Washington Ave, Cleveland, OH 44113-2333 | 2012-04-11 |
| 1326228602 | Robert Stetson, Md, Pllc | Clinic/Center | 2650 Executive Park Nw, Suite #3, Cleveland, TN 37312-2746 | 2007-11-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.