1093888752 NPI number — HEALTHIER BEGINNINGS HENRY COUNTY

Table of content: LEAH MARTIN M.A., BCBA (NPI 1851999460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093888752 NPI number — HEALTHIER BEGINNINGS HENRY COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHIER BEGINNINGS HENRY COUNTY
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:
1093888752
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11644 STATE ROUTE 424 STE 105
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPOLEON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43545-8002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-591-3857
Provider Business Mailing Address Fax Number:
419-591-3850

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11644 STATE ROUTE 424 STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPOLEON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43545-8002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-591-3857
Provider Business Practice Location Address Fax Number:
419-591-3850
Provider Enumeration Date:
11/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BORDENKIRCHER
Authorized Official First Name:
KIMBERLY
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
419-592-4015

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X , with the licence number:  270733 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2395895 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".