Healthcare Provider Details

I. General information

NPI: 1063330199
Provider Name (Legal Business Name): MONTI BEHAVIORAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 DEPOT ST STE B
WAUSEON OH
43567-1386
US

IV. Provider business mailing address

642 E ELM ST
WAUSEON OH
43567-1416
US

V. Phone/Fax

Practice location:
  • Phone: 520-213-5457
  • Fax:
Mailing address:
  • Phone: 520-213-5457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JULIO ADRIAN SAAVEDRA MONTIJO
Title or Position: CEO/COUNSELOR
Credential: LICDC, LIAC, LCAC
Phone: 520-213-5457