Provider Demographics
NPI:1831886563
Name:UNISON BEHAVIORAL HEALTH GROUP
Entity type:Organization
Organization Name:UNISON BEHAVIORAL HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING/REV CYCLE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-936-7346
Mailing Address - Street 1:1425 STARR AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43605-2456
Mailing Address - Country:US
Mailing Address - Phone:419-693-0631
Mailing Address - Fax:419-936-7606
Practice Address - Street 1:1425 STARR AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-2456
Practice Address - Country:US
Practice Address - Phone:419-693-0631
Practice Address - Fax:419-936-7606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty