Healthcare Provider Details

I. General information

NPI: 1730336025
Provider Name (Legal Business Name): CENTRAL OHIO MENTAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S HENRY ST
DELAWARE OH
43015-2978
US

IV. Provider business mailing address

250 S HENRY ST
DELAWARE OH
43015-2978
US

V. Phone/Fax

Practice location:
  • Phone: 740-369-4482
  • Fax: 740-369-4908
Mailing address:
  • Phone: 740-369-4482
  • Fax: 740-369-4908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. KEELY A SMITH
Title or Position: DIRECTOR OF MIS
Credential:
Phone: 740-368-7821