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General NPI Number Information
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NPI Number | 1063779460
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Entity Type | Organization
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Legal Business Name | CEDAR RIDGE BEHAVIORAL HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 841 STEUBENVILLE AVE
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City | CAMBRIDGE
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State | OH
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Zip | 43725-2301
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Country | US
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Telephone | 855-692-7247
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 WOODLAWN AVE SUITE112
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City | CAMBRIDGE
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State | OH
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Zip | 43725-3094
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Country | US
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Telephone | 855-692-7247
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. ALICIA JEAN BEYNON
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Credential | LISW-S, LICDC-CS
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Telephone | 855-692-7247
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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 | I.0700055-SUPV
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License Number State | OH
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