Organization
FRONTLINE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY RENNE BURNETT LPN (MENTAL HEALTH NURSE)
(216) 651-9950
Entity
Organization
Contact information
Practice address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
(216) 651-9950
(216) 651-9951
Mailing address
1744 PAYNE AVE, CLEVELAND, OH 44114-2910
(216) 651-9950
(216) 651-9951
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PN137174-M-IV
OH
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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