MEDICARE: COMMUNITY MENTAL HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	102	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336190842
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY MENTAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	68353 BANNOCK RD
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-9736
Country	:	US
Telephone Number	:	740-695-9344
Fax Number	:	740-695-7777

Provider Business Practice Location Address
First Line	:	68353 BANNOCK RD
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-9736
Country	:	US
Telephone Number	:	740-695-9344
Fax Number	:	740-695-7777

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. MARY B DENOBLE
Credential	:	M.S.
Telephone Number	:	740-695-9344

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	08/22/2020

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Directions to “COMMUNITY MENTAL HEALTH SERVICES ” Practice Location

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