Provider Demographics
NPI:1689271827
Name:CHILLICOTHE ACUTE CARE CLINIC, INC.
Entity Type:Organization
Organization Name:CHILLICOTHE ACUTE CARE CLINIC, INC.
Other - Org Name:ANCHOR ADDICTION AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-285-0381
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70459-0160
Mailing Address - Country:US
Mailing Address - Phone:985-726-9605
Mailing Address - Fax:
Practice Address - Street 1:5555 AIRPORT HWY STE 132
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7380
Practice Address - Country:US
Practice Address - Phone:567-742-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0438588Medicaid