MEDICARE: PATTERNS BEHAVIORAL SERVICES OHIO INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	251S00000X	Community/Behavioral Health Agency
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
5	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1629569538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATTERNS BEHAVIORAL SERVICES OHIO INC

Provider Business Mailing Address
First Line	:	3020 SATURN ST STE 206
Second Line	:
City	:	BREA
State	:	CA
Zip	:	92821-6262
Country	:	US
Telephone Number	:	657-444-9002
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 5TH AVE
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024-1088
Country	:	US
Telephone Number	:	440-286-9141
Fax Number	:	714-677-1785

Authorized Official
Title or Position	:	CEO
Name	:	IHAB SHAHAWI
Credential	:
Telephone Number	:	657-206-9594

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	08/18/2023

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