Provider Demographics
NPI:1083975205
Name:MARION AREA COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:MARION AREA COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-387-5210
Mailing Address - Street 1:320 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-6310
Mailing Address - Country:US
Mailing Address - Phone:740-387-5210
Mailing Address - Fax:740-382-3713
Practice Address - Street 1:320 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-6310
Practice Address - Country:US
Practice Address - Phone:740-387-5210
Practice Address - Fax:740-382-3713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMA9245091Medicare UPIN