Provider Demographics
NPI:1699039487
Name:CENTER FOR BEHAVIORAL HEALTH, INC
Entity Type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:NOFFSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-783-9690
Mailing Address - Street 1:725 BOARDMAN-CANFIELD RD. BLDG. D
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512
Mailing Address - Country:US
Mailing Address - Phone:330-783-9690
Mailing Address - Fax:330-783-9693
Practice Address - Street 1:725 BOARDMAN-CANFIELD RD. BLDG. D
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-783-9690
Practice Address - Fax:330-783-9693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.049140251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3136485Medicaid
CO3279Medicare UPIN
OH3136485Medicaid