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NPI Code Detail

MEDICARE: GENERATIONS BEHAVIORAL HEALTH - GENEVA LLC

MEDICARE: GENERATIONS BEHAVIORAL HEALTH - GENEVA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283Q00000XPsychiatric Hospital000000OH

General Provider Information

NPI Number : 1851652515
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATIONS BEHAVIORAL HEALTH - GENEVA LLC
Provider Business Mailing Address
First Line : 20600 CHAGRIN BLVD
Second Line : SUITE 620
City : SHAKER HEIGHTS
State : OH
Zip : 44122-5327
Country : US
Telephone Number : 216-751-4762
Fax Number :
Provider Business Practice Location Address
First Line : 60 WEST ST
Second Line :
City : GENEVA
State : OH
Zip : 44041-9723
Country : US
Telephone Number : 216-751-4762
Fax Number :
Authorized Official
Title or Position : HOSPITAL ADMINISTRATOR
Name : MR. RICHARD WALTON WARDEN
Credential :
Telephone Number : 216-751-4762
Provider Enumeration Date : 05/30/2012
Last Update Date : 09/05/2012

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