| Mcintyre Center Inc. | |
|
6900 Ridge Rd Ste 202 Parma OH 44129-5650 | |
| (440) 887-1100 | |
| (440) 887-1103 |
| Full Name | Mcintyre Center Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6900 Ridge Rd Ste 202, Parma, Ohio |
| Authorized Official Name and Position | Kelley Mcintyre Deir (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4408871100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcintyre Center Inc. 6900 Ridge Rd Ste 202 Parma OH 44129-5650 Ph: (440) 887-1100 | Mcintyre Center Inc. 6900 Ridge Rd Ste 202 Parma OH 44129-5650 Ph: (440) 887-1100 |
| NPI Number | 1023453867 |
|---|---|
| Provider Enumeration Date | 05/07/2013 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Medicare PECOS PAC ID | 2567998719 |
|---|---|
| Medicare Enrollment ID | O20241211001078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023453867 | NPI | - | NPPES |
| 0090022 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2540 (Ohio) | Primary |
| Provider Name | Jehad Iskandar Deir |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083079800 PECOS PAC ID: 8921534181 Enrollment ID: I20241220003486 |
| Provider Name | Gennadiy Bondarchuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871266262 PECOS PAC ID: 9335661719 Enrollment ID: I20250314000468 |
| Provider Name | B. Brando Tupaz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982900775 PECOS PAC ID: 9830625094 Enrollment ID: I20250423003340 |
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