| Cleveland Behavioral Health, Pllc | |
|
3555 Keith St Nw Suite 102 Cleveland TN 37312-4375 | |
| (423) 728-2282 | |
| (423) 728-2234 |
| Full Name | Cleveland Behavioral Health, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3555 Keith St Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Niansen Liu (OWNER) |
| Authorized Official Contact | 4237282282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleveland Behavioral Health, Pllc 3555 Keith St Nw Suite 102 Cleveland TN 37312-4375 Ph: (423) 728-2282 | Cleveland Behavioral Health, Pllc 3555 Keith St Nw Suite 102 Cleveland TN 37312-4375 Ph: (423) 728-2282 |
| NPI Number | 1396923553 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 07/25/2009 |
| Medicare PECOS PAC ID | 4183701576 |
|---|---|
| Medicare Enrollment ID | O20080409000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396923553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 36406 (Tennessee) | Primary |
| Provider Name | Niansen Liu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679578371 PECOS PAC ID: 8123073517 Enrollment ID: I20050318000173 |
| Provider Name | Lori A Firestone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922145283 PECOS PAC ID: 9931115185 Enrollment ID: I20060227000260 |
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