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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
110343OTHEROHMACSIS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811966401
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 : 614-644-5331
Provider Business Practice Location Address
First Line : 1101 SUMMIT RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-2621
Country : US
Telephone Number : 513-948-3600
Fax Number : 513-948-3080
Authorized Official
Title or Position : FISCAL MANAGER
Name : MS. TONYA MARIE FASONE
Credential :
Telephone Number : 614-466-9930
Provider Enumeration Date : 03/16/2006
Last Update Date : 01/29/2008

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

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