Provider Demographics
NPI:1245288448
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 1:320 GYPSY LANE RD.
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-4506
Practice Address - Country:US
Practice Address - Phone:419-352-5387
Practice Address - Fax:419-352-5439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1436261QR0405X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Not Answered251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1436OtherMACSIS UPI
OH2474068Medicaid
OH1436OtherMACSIS UPI