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Organization
MAHOGANY BRIDGES MENTAL HEALTH SERVICES LLC
Active
Organization
MAHOGANY BRIDGES MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARQUITA THOMPSON (CEO)
(330) 518-2888
Entity
Organization
Contact information
Practice address
2555 SOUTH DIXIE DRIVE SUITE 102, DAYTON, OH 45409
(330) 518-2888
Mailing address
743 KNICKERBOCKER AVE, SPRINGFIELD, OH 45506-3319
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251B00000X
Case Management Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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