Provider Demographics
NPI:1174680557
Name:OHIOGUIDESTONE
Entity Type:Organization
Organization Name:OHIOGUIDESTONE
Other - Org Name:GUIDESTONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-260-8327
Mailing Address - Street 1:434 EASTLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-2058
Mailing Address - Country:US
Mailing Address - Phone:800-234-2006
Mailing Address - Fax:440-260-8305
Practice Address - Street 1:202 EAST BAGLEY ROAD
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:OH
Practice Address - Zip Code:44017-2058
Practice Address - Country:US
Practice Address - Phone:800-234-2006
Practice Address - Fax:440-260-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2847067Medicaid
OH3139955Medicaid
OH2847067Medicaid