MEDICARE: OHIO GUIDESTONE

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	S.0031098	OH

General Provider Information

NPI Number	:	1942617030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO GUIDESTONE

Provider Business Mailing Address
First Line	:	52327 STATE ROUTE 18 WEST
Second Line	:
City	:	WELLINGTON
State	:	OH
Zip	:	44090
Country	:	US
Telephone Number	:	440-309-8696
Fax Number	:

Provider Business Practice Location Address
First Line	:	2173 NORTH RIDGE ROAD, SUITE E
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055
Country	:	US
Telephone Number	:	440-241-5896
Fax Number	:

Authorized Official
Title or Position	:	COMMUNITY THERAPIST
Name	:	MRS. PAULA THOMAS-GEREKE
Credential	:	MSSA, LSW
Telephone Number	:	440-309-8696

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	07/21/2014

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Directions to “OHIO GUIDESTONE ” 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.

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