Healthcare Provider Details

I. General information

NPI: 1629569538
Provider Name (Legal Business Name): PATTERNS BEHAVIORAL SERVICES OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2018
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 5TH AVE
CHARDON OH
44024-1088
US

IV. Provider business mailing address

3020 SATURN ST STE 206
BREA CA
92821-6262
US

V. Phone/Fax

Practice location:
  • Phone: 440-286-9141
  • Fax: 714-677-1785
Mailing address:
  • Phone: 657-444-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: IHAB SHAHAWI
Title or Position: CEO
Credential:
Phone: 657-206-9594