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General NPI Number Information
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NPI Number | 1720341175
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Entity Type | Organization
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Legal Business Name | OHIOGUIDESTONE
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 25701 N LAKELAND BLVD #403
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City | EUCLID
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State | OH
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Zip | 44132-2450
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Country | US
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Telephone | 440-260-6122
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Fax | 216-731-8335
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Provider Business Mailing Address
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Address Line | 434 EASTLAND RD.
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City | BEREA
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State | OH
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Zip | 44017-2058
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Country | US
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Telephone | 440-260-8327
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Fax | 440-234-8319
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Authorized Official
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Title or Position | VICE PRES, CHIEF CLINICAL OFFICER
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Name | DR. BEN KEARNEY
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Credential | PH.D.
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Telephone | 440-260-8300
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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 |
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License Number State |
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