| Lutheran Hospital | |
|
1730 W 25th St Cleveland OH 44113-3108 | |
| (216) 696-4300 | |
| Not Available |
| Full Name | Lutheran Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1730 W 25th St, Cleveland, Ohio |
| Authorized Official Name and Position | Timothy L. Longville (CHIEF ACCT. OFFICER AND CONTROLLER) |
| Authorized Official Contact | 2166367416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Hospital 6801 Brecksville Rd Suite 20 Rk10 Independence OH 44131-5032 Ph: (216) 636-8051 | Lutheran Hospital 1730 W 25th St Cleveland OH 44113-3108 Ph: (216) 696-4300 |
| NPI Number | 1003854951 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 03/30/2022 |
| Certification Date | 03/30/2022 |
| Medicare PECOS PAC ID | 2466358387 |
|---|---|
| Medicare Enrollment ID | O20110803000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003854951 | NPI | - | NPPES |
| 100135 | Other | KAISER | |
| 5381656 | Other | UNITED HEALTHCARE | |
| 0064535 | Other | AETNA | |
| 000000074006 | Other | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 1149 (Ohio) | Primary |
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