Provider Demographics
NPI:1558520932
Name:PLANNED LIFETIME ASSISTANCE NETWORK OF NORTHEAST OHIO, INC.
Entity Type:Organization
Organization Name:PLANNED LIFETIME ASSISTANCE NETWORK OF NORTHEAST OHIO, INC.
Other - Org Name:PLAN OF NE OHIO, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:T
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-321-3611
Mailing Address - Street 1:5010 MAYFIELD RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2695
Mailing Address - Country:US
Mailing Address - Phone:216-321-3611
Mailing Address - Fax:216-321-0021
Practice Address - Street 1:5010 MAYFIELD RD
Practice Address - Street 2:SUITE 304
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2695
Practice Address - Country:US
Practice Address - Phone:216-321-3611
Practice Address - Fax:216-321-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 0002706251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management