Provider Demographics
NPI:1063486058
Name:STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Entity Type:Organization
Organization Name:STATE OF OHIO OFFICE OF BUDGET AND MANAGEMENT STATE ACCOUNTING
Other - Org Name:APPALACHIAN BEHAVIORAL HEALTHCARE, ATHENS CAMPUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-594-5000
Mailing Address - Street 1:30 E BROAD ST
Mailing Address - Street 2:11TH FL, ATTN:TONYA FASONE
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-3414
Mailing Address - Country:US
Mailing Address - Phone:614-466-9930
Mailing Address - Fax:614-644-9116
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2301
Practice Address - Country:US
Practice Address - Phone:614-594-5000
Practice Address - Fax:740-594-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0150303Medicaid
OH9320392Medicare PIN
OH36-4015Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID