Healthcare Provider Details

I. General information

NPI: 1609466168
Provider Name (Legal Business Name): BEYOND BEHAVIORAL HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 01/19/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 W CENTRAL AVE STE A
TOLEDO OH
43606-2956
US

IV. Provider business mailing address

3110 W CENTRAL AVE STE A
TOLEDO OH
43606-2956
US

V. Phone/Fax

Practice location:
  • Phone: 513-900-0431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
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: LISA RICHARDSON
Title or Position: CEO & CO-FOUNDER
Credential:
Phone: 513-900-0431