Provider Demographics
NPI:1598221723
Name:THE DOROTHY L. VAUGHN BEHAVIORAL AND MENTAL HEALTH SERVICES, LLC.
Entity Type:Organization
Organization Name:THE DOROTHY L. VAUGHN BEHAVIORAL AND MENTAL HEALTH SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:216-926-3988
Mailing Address - Street 1:24800 CHAGRIN BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5631
Mailing Address - Country:US
Mailing Address - Phone:216-926-3988
Mailing Address - Fax:216-896-9997
Practice Address - Street 1:5900 STEWART AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-3901
Practice Address - Country:US
Practice Address - Phone:725-221-9686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health