Organization
STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
Active
Other names
HB - Child and Family Intervention Team 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
3076A REMSEN RD, MEDINA, OH 44256-9225
(330) 722-0750
(330) 723-0068
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
—
01565
MACSIS
OH
Enumeration date
03/14/2006
Last updated
01/29/2008
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