| Fairmount Professional Services, Inc | |
|
2490 Lee Blvd Suite 314 Cleveland Heights OH 44118-1268 | |
| (216) 321-6624 | |
| Not Available |
| Full Name | Fairmount Professional Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2490 Lee Blvd, Cleveland Heights, Ohio |
| Authorized Official Name and Position | Melvin Eugene Allerhand (PRESIDENT) |
| Authorized Official Contact | 2163216624 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmount Professional Services, Inc 2490 Lee Blvd Suite 314 Cleveland Heights OH 44118-1268 Ph: (216) 321-6624 | Fairmount Professional Services, Inc 2490 Lee Blvd Suite 314 Cleveland Heights OH 44118-1268 Ph: (216) 321-6624 |
| NPI Number | 1215264056 |
|---|---|
| Provider Enumeration Date | 11/16/2009 |
| Last Update Date | 11/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215264056 | NPI | - | NPPES |
| 400935 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 137 (Ohio) | Primary |
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