Provider Demographics
NPI:1407436231
Name:LANDMARK BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:LANDMARK BEHAVIORAL HEALTH, LLC
Other - Org Name:LANDMARK BEHAVIORAL HEALTH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-815-6049
Mailing Address - Street 1:3757 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9373
Mailing Address - Country:US
Mailing Address - Phone:740-815-6049
Mailing Address - Fax:
Practice Address - Street 1:3757 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9373
Practice Address - Country:US
Practice Address - Phone:740-815-6049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANDMARK BEHAVIORAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-14
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty