| Kindred Harbor Behavioral Health, Llc | |
|
1440 Rockside Rd Ste 216 Parma OH 44134-2749 | |
| (216) 408-9355 | |
| Not Available |
| Full Name | Kindred Harbor Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1440 Rockside Rd Ste 216, Parma, Ohio |
| Authorized Official Name and Position | Mutajah S Hussein (CO-OWNER) |
| Authorized Official Contact | 2164089355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kindred Harbor Behavioral Health, Llc 1440 Rockside Rd Ste 216 Parma OH 44134-2749 Ph: (216) 408-9355 | Kindred Harbor Behavioral Health, Llc 1440 Rockside Rd Ste 216 Parma OH 44134-2749 Ph: (216) 408-9355 |
| NPI Number | 1225605629 |
|---|---|
| Provider Enumeration Date | 06/05/2021 |
| Last Update Date | 07/02/2021 |
| Certification Date | 07/02/2021 |
| Medicare PECOS PAC ID | 5092113506 |
|---|---|
| Medicare Enrollment ID | O20211014001340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225605629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mutajah S Hussein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154980662 PECOS PAC ID: 3678975935 Enrollment ID: I20210708001954 |
| Provider Name | Alexandra N Holloway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689131070 PECOS PAC ID: 7214452648 Enrollment ID: I20250418000388 |
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