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 |