Organization
MARYHAVEN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MICHAEL RITTER LPCC, LICDC-CS (BILLING/MEDICAL RECORDS ADMINISTRAT)
(614) 324-5402
Entity
Organization
Contact information
Practice address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
(614) 324-5402
(614) 827-8380
Mailing address
1791 ALUM CREEK DR, COLUMBUS, OH 43207-1708
(614) 324-5402
(614) 827-8380
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1183
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
1183
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2846951
—
OH
Enumeration date
03/23/2006
Last updated
10/11/2017
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