Provider Demographics
NPI:1578345781
Name:CONNEXION WEST
Entity Type:Organization
Organization Name:CONNEXION WEST
Other - Org Name:CONNEXION BEHAVIORAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BURBRIDGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:COOK
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:740-201-2778
Mailing Address - Street 1:625 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2432
Mailing Address - Country:US
Mailing Address - Phone:740-201-2778
Mailing Address - Fax:
Practice Address - Street 1:625 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2432
Practice Address - Country:US
Practice Address - Phone:740-201-2778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health