Organization
ACCESS BEHAVIORAL LLC
Active
Parent organization
ACCESS BEHAVIORAL LLC
Other names
ACCESS HEALTH NETWORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACCESS BEHAVIORAL LLC
Authorized official
SRINIVAS PONNERI (MANAGER)
(614) 373-4202
Entity
Organization
Contact information
Practice address
15047 STATE ROUTE 309, KENTON, OH 43326-9701
(419) 673-0595
Mailing address
15047 STATE ROUTE 309, KENTON, OH 43326-9701
(419) 673-0595
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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