1003883075 NPI number — ALLWELL BEHAVIORAL HEALTH SERVICES

Table of content: (NPI 1003883075)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003883075 NPI number — ALLWELL BEHAVIORAL HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLWELL BEHAVIORAL HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SIX COUNTY, INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003883075
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2845 BELL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ZANESVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43701-1720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-454-9766
Provider Business Mailing Address Fax Number:
740-588-6452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2845 BELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ZANESVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43701-1720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-454-9766
Provider Business Practice Location Address Fax Number:
740-588-6452
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCDONALD
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
740-454-9766

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 162223000 . This is a "MAGELLAN GROUP PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 7492 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23342000 . This is a "MAGELLAN FACILITY PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2482344 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5903575 . This is a "AETNA PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: F10106 . This is a "MOUNT CARMEL PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0993653 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2408657 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06093 . This is a "ODMH MACSIS PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 218933 . This is a "TRICARE/MHN PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 056249 . This is a "VALUE OPTIONS PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1044424 . This is a "CIGNA GROUP PIN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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