Healthcare Provider Details

I. General information

NPI: 1639145444
Provider Name (Legal Business Name): MORGAN BEHAVIORAL HEALTH CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 S RIVERSIDE DR NE
MC CONNELSVILLE OH
43756-9102
US

IV. Provider business mailing address

915 S RIVERSIDE DR NE P.O. BOX 522
MC CONNELSVILLE OH
43756-9102
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-6933
  • Fax: 740-962-6305
Mailing address:
  • Phone: 740-962-6933
  • Fax: 740-962-6305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number1547
License Number StateOH

VIII. Authorized Official

Name: MS. ELAINE SHUSTER
Title or Position: EXECUTIVE DIRECTOR
Credential: LCDCIII, OCPSII
Phone: 740-962-6933