MEDICARE: OHIOGUIDESTONE

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720341175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIOGUIDESTONE

Provider Business Mailing Address
First Line	:	434 EASTLAND RD.
Second Line	:
City	:	BEREA
State	:	OH
Zip	:	44017-2058
Country	:	US
Telephone Number	:	440-260-8327
Fax Number	:	440-234-8319

Provider Business Practice Location Address
First Line	:	25701 N LAKELAND BLVD
Second Line	:	#403
City	:	EUCLID
State	:	OH
Zip	:	44132-2450
Country	:	US
Telephone Number	:	440-260-6122
Fax Number	:	216-731-8335

Authorized Official
Title or Position	:	VICE PRES, CHIEF CLINICAL OFFICER
Name	:	DR. BEN KEARNEY
Credential	:	PH.D.
Telephone Number	:	440-260-8300

Provider Enumeration Date	:	06/20/2012
Last Update Date	:	06/16/2018

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Directions to “OHIOGUIDESTONE ” Practice Location

Language	Start Address	Practice Location

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