Provider Demographics
| NPI: | 1356307235 |
|---|---|
| Name: | MERIDIAN HEALTHCARE |
| Entity type: | Organization |
| Organization Name: | MERIDIAN HEALTHCARE |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | VICE PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DARLA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | GALLAGHER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 330-797-0070 |
| Mailing Address - Street 1: | 527 N MERIDIAN RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | YOUNGSTOWN |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 44509-1227 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 330-797-0070 |
| Mailing Address - Fax: | 330-797-9146 |
| Practice Address - Street 1: | 527 N MERIDIAN RD |
| Practice Address - Street 2: | |
| Practice Address - City: | YOUNGSTOWN |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 44509-1227 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 330-797-0070 |
| Practice Address - Fax: | 330-797-9146 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-04-21 |
| Last Update Date: | 2025-04-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
| No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 163WA0400X | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
| No | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | Group - Multi-Specialty | |
| No | 172V00000X | Other Service Providers | Community Health Worker | Group - Multi-Specialty | |
| No | 175T00000X | Other Service Providers | Peer Specialist | Group - Multi-Specialty | |
| No | 2084A0401X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | Group - Multi-Specialty |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 405300000X | Other Service Providers | Prevention Professional | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| OH | 2864520 | Medicaid | |
| OH | 0095633 | Medicaid | |
| OH | 2863781 | Medicaid | |
| MA9227381 | Medicare UPIN |