Healthcare Provider Details

I. General information

NPI: 1528237195
Provider Name (Legal Business Name): WESTWOOD BEHAVIORAL HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1158 WESTWOOD DR
VAN WERT OH
45891-2449
US

IV. Provider business mailing address

1158 WESTWOOD DR
VAN WERT OH
45891-2449
US

V. Phone/Fax

Practice location:
  • Phone: 419-238-3434
  • Fax: 419-238-1955
Mailing address:
  • Phone: 419-238-3434
  • Fax: 419-238-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LYNN A JOHNSON
Title or Position: CFO
Credential:
Phone: 419-238-3434