Wallace, Steven E

Wallace, Steven E is an sole proprietor health care provider with primary practice located at 30800 Chagrin Blvd , Cleveland OH 44124-5925. He recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as his primary health care specialty. Wallace, Steven E can be contacted via phone (216) 591-0324.

Contact Information

Primary practice address
30800 Chagrin Blvd Cleveland OH 44124-5925
Fax: (216) 591-1243
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X CDCA.162346 Ohio

Profile Details

NPI number 1073029864
LBN Legal business name Wallace, Steven E
Credentials CDCA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 16th, 2017
Last updated Dec 16th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073029864 NPPES
Ohio MEDICAID 2374229

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