Provider Demographics
NPI:1922543982
Name:EMPOWERING INTEGRATED CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:EMPOWERING INTEGRATED CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:216-532-3427
Mailing Address - Street 1:23215 COMMERCE PARK STE 306
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5843
Mailing Address - Country:US
Mailing Address - Phone:216-532-3427
Mailing Address - Fax:216-502-2803
Practice Address - Street 1:23215 COMMERCE PARK STE 306
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5843
Practice Address - Country:US
Practice Address - Phone:216-532-3427
Practice Address - Fax:216-502-2803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-30
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01-7569261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)