Healthcare Provider Details

I. General information

NPI: 1275182958
Provider Name (Legal Business Name): MICHAEL JONES QMHS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 S HIGH ST
COLUMBUS OH
43206-1928
US

IV. Provider business mailing address

3170 W CENTRAL AVE
TOLEDO OH
43606-2945
US

V. Phone/Fax

Practice location:
  • Phone: 614-445-8131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number169923
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: