Healthcare Provider Details

I. General information

NPI: 1841132073
Provider Name (Legal Business Name): HOMETOWN BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7709 HOKE RD
ENGLEWOOD OH
45315-9725
US

IV. Provider business mailing address

7709 HOKE RD
ENGLEWOOD OH
45315-9725
US

V. Phone/Fax

Practice location:
  • Phone: 937-809-2940
  • Fax: 937-809-2941
Mailing address:
  • Phone: 937-809-2940
  • Fax: 937-809-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CAROL BLAND
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 937-809-2940