Provider Demographics
NPI:1295868651
Name:STRESSCARE BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:STRESSCARE BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:I
Authorized Official - Last Name:SWIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-531-3500
Mailing Address - Street 1:3840 WOODLEY ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606
Mailing Address - Country:US
Mailing Address - Phone:419-531-3500
Mailing Address - Fax:419-531-1877
Practice Address - Street 1:3840 WOODLEY RD.
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606
Practice Address - Country:US
Practice Address - Phone:419-531-3500
Practice Address - Fax:419-531-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3680103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0911811Medicaid
OH9316281Medicare ID - Type Unspecified