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General NPI Number Information
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NPI Number | 1063539997
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Entity Type | Organization
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Legal Business Name | JEFFERSON BEHAVIORAL HEALTH SYSTEM
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 1 ROSS PARK BLVD SUITE 201
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2681
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Country | US
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Telephone | 740-264-7751
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Fax | 740-264-2422
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Provider Business Mailing Address
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Address Line | 1 ROSS PARK BLVD SUITE 201
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2681
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Country | US
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Telephone | 740-264-7751
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Fax | 740-264-2422
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ANTHONY J SHEPOSH
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Credential | LPC
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Telephone | 740-264-7751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0191
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1308
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1310
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License Number State | OH
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