Provider Demographics
NPI:1598010233
Name:OHIOGUIDESTONE
Entity Type:Organization
Organization Name:OHIOGUIDESTONE
Other - Org Name:BEREA CHILDREN'S HOME AND FAMILY SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-260-8300
Mailing Address - Street 1:434 EASTLAND RD.
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:440-260-8327
Mailing Address - Fax:440-234-8319
Practice Address - Street 1:3500 CARNEGIE AVENUE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-2651
Practice Address - Country:US
Practice Address - Phone:440-234-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS21115251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health