Provider Demographics
NPI:1881059780
Name:COMMUNITY HEALTHCARE ASSOCIATES OF OHIO, LLC
Entity type:Organization
Organization Name:COMMUNITY HEALTHCARE ASSOCIATES OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:LARRICK
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:740-685-1610
Mailing Address - Street 1:209 SENECA AVE., UNIT D
Mailing Address - Street 2:P.O. BOX 112
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43723
Mailing Address - Country:US
Mailing Address - Phone:740-685-1610
Mailing Address - Fax:740-685-1610
Practice Address - Street 1:209 SENECA AVE UNIT D
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1364
Practice Address - Country:US
Practice Address - Phone:740-685-1610
Practice Address - Fax:740-685-1610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-18
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-1153261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health