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General NPI Number Information
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NPI Number | 1609689033
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Entity Type | Organization
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Legal Business Name | ANEW BEHAVIORAL HEALTH OF INDIANA
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST STE D
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City | ATHENS
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State | OH
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Zip | 45701-1870
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Country | US
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Telephone | 866-534-2639
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Fax |
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Provider Business Mailing Address
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Address Line | 765 N DETROIT ST
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City | XENIA
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State | OH
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Zip | 45385-1960
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JENNIE EWALD
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Credential |
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Telephone | 937-414-1948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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