Organization
LICKING MEMORIAL PROFESSIONAL CORP.
Active
Other names
Licking Memorial Behavioral Health Pataskala
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT MONTAGNESE (EXECUTIVE VICE PRESIDENT)
(740) 348-4000
Entity
Organization
Contact information
Practice address
1 HEALTHY PL, SUITE 105, PATASKALA, OH 43062-7067
(740) 348-1930
(740) 348-1931
Mailing address
1 HEALTHY PL, SUITE 105, PATASKALA, OH 43062-7067
(740) 348-1930
(740) 348-1931
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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