Organization
OHIOGUIDESTONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY JACKSON (BILLING SUPERVISOR)
(440) 260-8328
Entity
Organization
Contact information
Practice address
202 E BAGLEY RD, BEREA, OH 44017-2058
(800) 234-2006
(440) 260-8305
Mailing address
202 E BAGLEY RD, BEREA, OH 44017-2058
(800) 234-2006
(440) 260-8305
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2141426
—
OH
Enumeration date
05/31/2012
Last updated
04/16/2014
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