| Renaissance Behavioral Health Llc | |
|
3740 Euclid Ave Ste 101 Cleveland OH 44115-2229 | |
| (440) 606-2003 | |
| (216) 785-9200 |
| Full Name | Renaissance Behavioral Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3740 Euclid Ave Ste 101, Cleveland, Ohio |
| Authorized Official Name and Position | Lisa Sullivan (ACCESS MANAGER) |
| Authorized Official Contact | 4406062003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Behavioral Health Llc 3740 Euclid Ave Ste 101 Cleveland OH 44115-2229 Ph: (440) 606-2003 | Renaissance Behavioral Health Llc 3740 Euclid Ave Ste 101 Cleveland OH 44115-2229 Ph: (440) 606-2003 |
| NPI Number | 1689251845 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 03/25/2021 |
| Certification Date | 03/25/2021 |
| Medicare PECOS PAC ID | 3375967854 |
|---|---|
| Medicare Enrollment ID | O20210914000819 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689251845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Peter Golden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588867626 PECOS PAC ID: 0749350882 Enrollment ID: I20080602000671 |
| Provider Name | Kimberly Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578752267 PECOS PAC ID: 7719137298 Enrollment ID: I20130109000235 |
| Provider Name | Stephanie T Tamburro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659678217 PECOS PAC ID: 6901234137 Enrollment ID: I20200320002186 |
| Provider Name | Quinta E Tangoh |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1871188367 PECOS PAC ID: 7618369901 Enrollment ID: I20220118002463 |
| Provider Name | Maureen M Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316357080 PECOS PAC ID: 3476919895 Enrollment ID: I20230628002755 |
| Provider Name | Raphaelle Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508228446 PECOS PAC ID: 0648631754 Enrollment ID: I20230925000192 |
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