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NPI Code Detail

MEDICARE: MENTAL HEALTH SERVICES FOR HOMELESS PERSONS, INC.

MEDICARE: MENTAL HEALTH SERVICES FOR HOMELESS PERSONS, INC.
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
1251B00000XCase Management AgencyOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639140395
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENTAL HEALTH SERVICES FOR HOMELESS PERSONS, INC.
Provider Business Mailing Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number : 216-623-6539
Provider Business Practice Location Address
First Line : 1744 PAYNE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44114-2910
Country : US
Telephone Number : 216-623-6555
Fax Number : 216-623-6539
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. SUSAN NETH
Credential : MS, LSW
Telephone Number : 216-623-6555
Provider Enumeration Date : 01/31/2006
Last Update Date : 07/21/2022

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1063469112 — ALF H BERGMAN MD
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