Provider Demographics
NPI:1255308136
Name:SCIOTO PAINT VALLEY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:SCIOTO PAINT VALLEY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOLLOW UP SPECIALIST/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DEBI
Authorized Official - Middle Name:
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-772-7909
Mailing Address - Street 1:4449 STATE ROUTE 159
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8620
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:740-775-0292
Practice Address - Street 1:4449 STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8620
Practice Address - Country:US
Practice Address - Phone:740-775-1260
Practice Address - Fax:740-775-0292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000003420OtherANTHEM
OH2401332Medicaid
OH2921253Medicaid
OH9177906Medicare PIN
OH9177909Medicare PIN
OH9177904Medicare PIN
OH9177903Medicare PIN
OH000000003420OtherANTHEM