Provider Demographics
NPI:1679323547
Name:FORT MEIGS WELLNESS & BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:FORT MEIGS WELLNESS & BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUGHHORN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-874-8257
Mailing Address - Street 1:975 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5228
Mailing Address - Country:US
Mailing Address - Phone:419-874-8257
Mailing Address - Fax:419-873-7584
Practice Address - Street 1:975 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5228
Practice Address - Country:US
Practice Address - Phone:419-874-8257
Practice Address - Fax:419-873-7584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty