=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932177789
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADRIEL SCHOOL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2006
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 S MAIN ST
-----------------------------------------------------
City | BELLEFONTAINE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43311-1508
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-465-0010
-----------------------------------------------------
Fax | 937-465-8690
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 188
-----------------------------------------------------
City | WEST LIBERTY
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43357-0188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-465-0010
-----------------------------------------------------
Fax | 937-465-8690
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF CLINICAL SERVICES
-----------------------------------------------------
Name | MR. JEFFREY SLOAT
-----------------------------------------------------
Credential | LISW-S
-----------------------------------------------------
Telephone | 614-588-7182
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0855X
-----------------------------------------------------
Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
-----------------------------------------------------
License Number | 0570
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------