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NPI Code Detail

MEDICARE: BOBBY HASAN QMHS

MEDICARE: BOBBY HASAN QMHS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1467202333
Entity Type Code : Individual
Provider Name (Legal Business Name) : BOBBY HASAN QMHS
Provider Business Mailing Address
First Line : 4517 RENAISSANCE PKWY
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5701
Country : US
Telephone Number : 216-360-9343
Fax Number : 216-360-9345
Provider Business Practice Location Address
First Line : 4517 RENAISSANCE PKWY
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5701
Country : US
Telephone Number : 216-360-9343
Fax Number : 216-360-9345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2024
Last Update Date : 03/25/2024

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