Provider Demographics
NPI:1710033568
Name:TOLEDO CENTER FOR EATING DISORDERS LLC
Entity Type:Organization
Organization Name:TOLEDO CENTER FOR EATING DISORDERS LLC
Other - Org Name:ASTER SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNACKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-864-8154
Mailing Address - Street 1:5465 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2155
Mailing Address - Country:US
Mailing Address - Phone:419-885-8800
Mailing Address - Fax:419-885-8600
Practice Address - Street 1:5465 MAIN ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2155
Practice Address - Country:US
Practice Address - Phone:419-885-8800
Practice Address - Fax:419-885-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0453251S00000X
OHRF-03-1964320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2052228Medicaid
OHT09295731Medicare ID - Type UnspecifiedMEDICARE