Provider Demographics
NPI:1912987371
Name:THE MARSH FOUNDATION
Entity Type:Organization
Organization Name:THE MARSH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PEASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-238-1695
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-0150
Mailing Address - Country:US
Mailing Address - Phone:419-238-1695
Mailing Address - Fax:419-238-1007
Practice Address - Street 1:1229 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-1877
Practice Address - Country:US
Practice Address - Phone:419-238-1695
Practice Address - Fax:419-238-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
OH0393261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846933Medicaid