Provider Demographics
NPI:1962460048
Name:BEHAVIORAL CONNECTIONS OF WOOD COUNTY INC.
Entity Type:Organization
Organization Name:BEHAVIORAL CONNECTIONS OF WOOD COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:CGFM
Authorized Official - Phone:419-352-5387
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-0029
Mailing Address - Country:US
Mailing Address - Phone:419-352-5387
Mailing Address - Fax:419-352-6033
Practice Address - Street 1:1010 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-1335
Practice Address - Country:US
Practice Address - Phone:419-352-5387
Practice Address - Fax:419-352-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0318251B00000X, 261QE0002X, 261QM0801X, 261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10348OtherMACSIS UPI
OH2474068Medicaid
OH9291811Medicare PIN