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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