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Jordan Community Residential Center

Addiction (Substance Use Disorder) Psychologist in Willoughby, OH · enumerated 2019 · authorized official Tenisha Gant, Chief Executive Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1164068524

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Registry record

Entity type Organization (Type 2)
Legal business name Jordan Community Residential Center
Practice address 30841 Euclid Ave Ste 103, Willoughby, OH, 44094
Phone (216) 441-2496
Fax (216) 634-9611
Enumeration date Nov 20, 2019
Last updated in NPPES Feb 4, 2025

Taxonomy & classification

103TA0400X Addiction (Substance Use Disorder) Psychologist Behavioral Health & Social Service Providers Primary

Authorized official

Name Tenisha Gant
Title Chief Executive Officer
Phone (216) 441-2496

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Jordan Community Residential Center located?
The practice location on file with NPPES is in Willoughby, OH.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-02-04. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-02-04.