Organization
MENTAL HEALTH SERVICES FOR CLARK AND MADISON CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES P PERRY PHD (CEO)
(937) 399-9500
Entity
Organization
Contact information
Practice address
1345 N FOUNTAIN BLVD, SPRINGFIELD, OH 45504-1422
(937) 399-9500
(937) 399-2701
Mailing address
1345 N FOUNTAIN BLVD, SPRINGFIELD, OH 45504-1422
(937) 399-9500
(937) 399-2701
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
006
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2485716
MEDICAID RISPERDAL BILL
OH
Enumeration date
03/10/2008
Last updated
03/10/2008
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