Provider Demographics
NPI:1225814643
Name:MARINIS PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:MARINIS PSYCHIATRY, LLC
Other - Org Name:FOREST CITY PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-279-3700
Mailing Address - Street 1:14837 DETROIT AVE # 512
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3909
Mailing Address - Country:US
Mailing Address - Phone:216-279-3700
Mailing Address - Fax:216-249-9196
Practice Address - Street 1:20525 CENTER RIDGE RD STE 502
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3424
Practice Address - Country:US
Practice Address - Phone:216-279-3700
Practice Address - Fax:216-249-9196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty