Provider Demographics
NPI:1639502529
Name:OHIO PSYCHIATRY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:OHIO PSYCHIATRY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALF
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-644-3785
Mailing Address - Street 1:6115 POWERS BLVD
Mailing Address - Street 2:SUITE 204, MEDICAL ARTS CENTER 4
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5471
Mailing Address - Country:US
Mailing Address - Phone:440-743-2128
Mailing Address - Fax:440-743-2122
Practice Address - Street 1:6115 POWERS BLVD
Practice Address - Street 2:SUITE 204, MEDICAL ARTS CENTER 4
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5471
Practice Address - Country:US
Practice Address - Phone:440-743-2128
Practice Address - Fax:440-743-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health