1427665900 NPI number — CENTER FOR EMOTIONAL HEALTH, LLC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427665900 NPI number — CENTER FOR EMOTIONAL HEALTH, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR EMOTIONAL HEALTH, LLC.
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:
Provider Other Organization Name Type Code:
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:
1427665900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3922 MENCHHOFER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLDWATER
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45828-8739
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
567-644-8186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 PORTLAND ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CELINA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45822-2038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
567-644-8186
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROSENBECK-ROSE
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
567-644-8186

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0043994 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".