Provider Demographics
NPI:1144021627
Name:DE LA CRUZ, ROBERT MORALES
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:MORALES
Last Name:DE LA CRUZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E DUBLIN GRANVILLE RD STE G
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3183
Mailing Address - Country:US
Mailing Address - Phone:330-596-1042
Mailing Address - Fax:
Practice Address - Street 1:6100 W CREEK RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2177
Practice Address - Country:US
Practice Address - Phone:216-262-0832
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician