Provider Demographics
NPI:1184677973
Name:MUSKINGUM COUNTY CHILDREN SERVICES OPTIONS PROGRAM
Entity Type:Organization
Organization Name:MUSKINGUM COUNTY CHILDREN SERVICES OPTIONS PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:740-455-6710
Mailing Address - Street 1:205 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-0157
Mailing Address - Country:US
Mailing Address - Phone:740-455-6710
Mailing Address - Fax:740-455-6719
Practice Address - Street 1:205 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43702-0157
Practice Address - Country:US
Practice Address - Phone:740-455-6710
Practice Address - Fax:740-455-6719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12226101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty