Provider Demographics
NPI:1790116747
Name:SCIOTO PAINT VALLEY MENTAL HEALTH CENTER
Entity Type:Organization
Organization Name:SCIOTO PAINT VALLEY MENTAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TRUMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-772-7877
Mailing Address - Street 1:4449 STATE ROUTE 159
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8620
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:
Practice Address - Street 1:4449 STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8620
Practice Address - Country:US
Practice Address - Phone:740-775-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9177907Medicare PIN
OH9177909Medicare PIN
OH9177901Medicare PIN
OH9177903Medicare PIN
OH9177906Medicare PIN
OH9177904Medicare PIN