Healthcare Provider Details
I. General information
NPI: 1053505339
Provider Name (Legal Business Name): WESTWOOD BEHAVIORAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2007
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 MC DONALD PIKE
PAULDING OH
45879
US
IV. Provider business mailing address
1158 WESTWOOD DR
VAN WERT OH
45891-2449
US
V. Phone/Fax
- Phone: 419-399-3636
- Fax: 419-399-5915
- Phone: 419-238-3434
- Fax: 419-238-1955
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | OH |
VIII. Authorized Official
Name: MR.
MARK
A
SPIELES
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LISW-S
Phone: 419-238-3434