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General NPI Number Information
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NPI Number | 1689846933
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Entity Type | Organization
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Legal Business Name | SAMARITAN BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 601 S EDWIN C MOSES BLVD NW BLDG. 1ST AND 4TH FLOORS
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City | DAYTON
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State | OH
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Zip | 45408-1424
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Country | US
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Telephone | 937-276-8333
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Fax | 937-276-8269
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Provider Business Mailing Address
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Address Line | 601 S EDWIN C MOSES BLVD
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City | DAYTON
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State | OH
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Zip | 45417-3424
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Country | US
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Telephone | 937-734-4334
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Fax | 937-734-8269
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Authorized Official
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Title or Position | BILLING
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Name | TABATHA L MASTERS
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Credential |
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Telephone | 937-734-4334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 503, 11127
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License Number State | OH
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