Provider Demographics
NPI:1780133504
Name:MENTAL HEALTH AND ADDITIVE SERVICES
Entity type:Organization
Organization Name:MENTAL HEALTH AND ADDITIVE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORRECTIIONAL PROGRAM COORNATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:GETTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:740-653-4324
Mailing Address - Street 1:5900 BIS RD SW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-9606
Mailing Address - Country:US
Mailing Address - Phone:740-653-4324
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 549
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:OH
Practice Address - Zip Code:43155-9627
Practice Address - Country:US
Practice Address - Phone:740-653-4324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHEASTERN CORRECTIONAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPCC-SE177324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility