Provider Demographics
NPI:1639131311
Name:MAUMEE RIVER BEHAVIORAL HEALTH CARE INC
Entity Type:Organization
Organization Name:MAUMEE RIVER BEHAVIORAL HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-661-2779
Mailing Address - Street 1:PO BOX 60347
Mailing Address - Street 2:
Mailing Address - City:ROSSFORD
Mailing Address - State:OH
Mailing Address - Zip Code:43460-1333
Mailing Address - Country:US
Mailing Address - Phone:419-661-2779
Mailing Address - Fax:419-661-0890
Practice Address - Street 1:922 DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:ROSSFORD
Practice Address - State:OH
Practice Address - Zip Code:43460-1333
Practice Address - Country:US
Practice Address - Phone:419-661-2779
Practice Address - Fax:419-661-0890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty