| Koinonia Behavioral Health, Llc | |
|
6161 Oak Tree Blvd Ste 230 Independence OH 44131-2581 | |
| (216) 588-8777 | |
| Not Available |
| Full Name | Koinonia Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6161 Oak Tree Blvd Ste 230, Independence, Ohio |
| Authorized Official Name and Position | Brian Hoyer (DIRECTOR OF QUALITY & COMPLIANCE) |
| Authorized Official Contact | 2165888777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koinonia Behavioral Health, Llc 6161 Oak Tree Blvd Ste 400 Independence OH 44131-2581 Ph: (216) 588-8777 | Koinonia Behavioral Health, Llc 6161 Oak Tree Blvd Ste 230 Independence OH 44131-2581 Ph: (216) 588-8777 |
| NPI Number | 1891433637 |
|---|---|
| Provider Enumeration Date | 05/23/2022 |
| Last Update Date | 05/23/2022 |
| Certification Date | 05/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891433637 | NPI | - | NPPES |
| 1407334824 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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