Organization
MARYMOUNT HOSPITAL INC
Active
Organization
MARYMOUNT HOSPITAL INC
Active
Other names
Marymount Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (EXECUTIVE VP CHIEF FINANCE OFFICER)
(216) 445-1343
Entity
Organization
Contact information
Practice address
12300 MCCRACKEN ROAD, GARFIELD HEIGHTS, OH 44125-2914
(216) 581-0500
Mailing address
6801 BRECKSVILLE RD, STE 20,ATTN: DPC RK2-7, INDEPENDENCE, OH 44131-5062
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
1136
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100107
KAISER
—
05
—
2915171
—
OH
01
—
5000046
UNITED HEALTHCARE
—
01
—
6460670
AETNA
—
Enumeration date
06/03/2006
Last updated
08/25/2025
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