Organization
PANNETTE BEHAVIORAL HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS PAUL PANNETTE LISW-S (PRESIDENT/OWNER)
(440) 627-6962
Entity
Organization
Contact information
Practice address
8000 TOWN CENTRE DR, SUITE 300, BROADVIEW HEIGHTS, OH 44147-4030
(440) 627-6962
(440) 627-6963
Mailing address
8000 TOWN CENTRE DR, SUITE 300, BROADVIEW HEIGHTS, OH 44147-4030
(440) 627-6962
(440) 627-6963
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
I0008711
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
094872000
MAGELLAN HEALTH SERIVCES
OH
01
—
515293
VALUE OPTIONS
OH
Enumeration date
03/13/2013
Last updated
03/13/2013
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