Organization
STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
Active
Other names
Washington Co Comm MH Services CSN
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONYA MARIE FASONE (FISCAL MANAGER)
(614) 466-9930
Entity
Organization
Contact information
Practice address
118 PUTNAM ST, MARIETTA, OH 45750-2923
(740) 374-6989
(740) 432-7567
Mailing address
30 E. BROAD ST, 11TH FLOOR - FISCAL ADMINISTRATION, COLUMBUS, OH 43215-3430
(614) 466-6583
(614) 644-5331
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10355
MACSIS
OH
05
—
2452233
—
OH
Enumeration date
03/14/2006
Last updated
01/29/2008
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