Healthcare Provider Details

I. General information

NPI: 1598635294
Provider Name (Legal Business Name): GPS BEHAVIORAL CARE OF OHIO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 INDIAN WOOD CIR STE 200
MAUMEE OH
43537-4055
US

IV. Provider business mailing address

1715 INDIAN WOOD CIR STE 200
MAUMEE OH
43537-4055
US

V. Phone/Fax

Practice location:
  • Phone: 877-906-9699
  • Fax: 888-483-0118
Mailing address:
  • Phone: 877-906-9699
  • Fax: 888-483-0118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CLEMENTE
Title or Position: ADMINISTRATOR
Credential: ESQ
Phone: 877-906-9699