MEDICARE: MR. CARL CHRISTOPHER BA,CDCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator	OH
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1972081719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL CHRISTOPHER BA,CDCA

Provider Business Mailing Address
First Line	:	74 BIRCKHEAD PL
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2321
Country	:	US
Telephone Number	:	419-283-0972
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 E MARKET ST
Second Line	:
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-222-4474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2018
Last Update Date	:	01/22/2026

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