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NPI Code Detail

MEDICARE: MENTAL HEALTH SERVICES FOR CLARK CO INC.

MEDICARE: MENTAL HEALTH SERVICES FOR CLARK CO INC.
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
1283Q00000XPsychiatric HospitalPPH-05-2406OH

Other Identifiers

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

General Provider Information

NPI Number : 1417948407
Entity Type Code : Organization
Provider Name (Legal Business Name) : MENTAL HEALTH SERVICES FOR CLARK CO INC.
Provider Business Mailing Address
First Line : 474 NORTH YELLOW SPRINGS STREET
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45504
Country : US
Telephone Number : 937-399-9500
Fax Number : 937-342-4242
Provider Business Practice Location Address
First Line : 474 NORTH YELLOW SPRINGS STREET
Second Line :
City : SPRINGFIELD
State : OH
Zip : 45504-2463
Country : US
Telephone Number : 937-399-9500
Fax Number : 937-342-4242
Authorized Official
Title or Position : CEO
Name : KELLY L RIGGER
Credential :
Telephone Number : 937-399-9500
Provider Enumeration Date : 10/31/2005
Last Update Date : 05/11/2021

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Directions to “MENTAL HEALTH SERVICES FOR CLARK CO INC. ” Practice Location

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