NPIMap

Organization Active NPI

Renaissance Behavioral Health LLC

  • Psychiatry Physician
  • Cleveland, OH
National Provider Identifier
1689251845
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
RENAISSANCE BEHAVIORAL HEALTH LLC
Practice address
3740 Euclid Ave Ste 101
Cleveland, OH 44115-2229
Phone
(440) 606-2003
Fax
(216) 785-9200
NPI assigned
Mar 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Sullivan
Title
Access Manager
Phone
(440) 606-2003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

3740 Euclid Ave Ste 101
Cleveland, OH 44115-2229

Mailing address

3740 Euclid Ave Ste 101
Cleveland, OH 44115-2229
Phone (440) 606-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210914000819 OH Part B Supplier - Clinic/Group Practice 3375967854 Receives reassigned benefits from 5 practitioners
Practice locations: Cleveland, OH

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Behavioral Health LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3740 Euclid Ave
Ste 101
Cleveland, OH 44115
Phone (440) 453-0754

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1689251845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 EUCLID AVE STE 101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152229",
            "telephone_number": "440-606-2003",
            "fax_number": "216-785-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 EUCLID AVE STE 101",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152229",
            "telephone_number": "440-606-2003",
            "fax_number": "216-785-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "440-606-2003"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.