Healthcare Provider Details

I. General information

NPI: 1285575761
Provider Name (Legal Business Name): PAMELA'S COZY COTTAGE RLLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6713 SUPERIOR AVE
CLEVELAND OH
44103-2631
US

IV. Provider business mailing address

25000 EUCLID AVE STE 108
EUCLID OH
44117-2621
US

V. Phone/Fax

Practice location:
  • Phone: 216-200-6254
  • Fax:
Mailing address:
  • Phone: 216-200-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: EON R FAWCETT
Title or Position: CEO
Credential:
Phone: 216-413-0890