DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: STATE OF OHIO DEPARTMENT OF MENTAL HEALTH

MEDICARE: STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
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
1251B00000XCase Management AgencyOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110019OTHEROHMACSIS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750350658
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
Provider Business Mailing Address
First Line : 30 E. BROAD ST
Second Line : 11TH FLOOR - FISCAL ADMINISTRATION
City : COLUMBUS
State : OH
Zip : 43215-3430
Country : US
Telephone Number : 614-466-6583
Fax Number : 614-466-5331
Provider Business Practice Location Address
First Line : 2611 WAYNE AVE
Second Line : BLDG #66
City : DAYTON
State : OH
Zip : 45420-1833
Country : US
Telephone Number : 937-258-0440
Fax Number : 937-258-6218
Authorized Official
Title or Position : FISCAL MANAGER
Name : MS. TONYA MARIE FASONE
Credential :
Telephone Number : 614-466-9930
Provider Enumeration Date : 03/15/2006
Last Update Date : 01/29/2008

Similar Medicare Providers

1912703570 — JIAIR JONES MCCLAIN
Practice Location Address:
2611 WAYNE AVE
DAYTON, OH
45420-1833
Practice Phone: 937-228-0579
Practice Fax:
1699863779 — DR. THOMAS L SOUTH PH.D.
Practice Location Address:
2611 WAYNE AVE
DAYTON, OH
45420-1833
Practice Phone: 937-258-0440
Practice Fax: 937-258-6203
1770660540 — PETER IVERSEN
Practice Location Address:
2611 WAYNE AVE
DAYTON, OH
45420-1833
Practice Phone: 937-258-0440
Practice Fax:
1114091758 — DR. VICTOR RICHARD KNAPP M.D.
Practice Location Address:
2611 WAYNE AVE
DAYTON, OH
45420-1833
Practice Phone: 937-258-6230
Practice Fax: 937-258-6273
1073672275 — GREGORY JOHN WIGHTMAN L.P.C.C. SUPV.
Practice Location Address:
2611 WAYNE AVE , BUILDING #66
DAYTON, OH
45420-1833
Practice Phone: 937-258-0440
Practice Fax: 937-258-6235
1144389313 — ELIZABETH SHARPLESS BONANNO M.D.
Practice Location Address:
2611 WAYNE AVE , BUILDING #66
DAYTON, OH
45420-1833
Practice Phone: 937-258-0440
Practice Fax: 937-258-6235

Directions to “STATE OF OHIO DEPARTMENT OF MENTAL HEALTH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.