Organization
SHAKER CLINIC, LLC
Active
Other names
Ohio Clinic for Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER L HOWARD (VP & SECRETARY)
(615) 861-6000
Entity
Organization
Contact information
Practice address
899 E BROAD ST, COLUMBUS, OH 43205-1156
(614) 928-9400
(614) 928-9401
Mailing address
6100 TOWER CIR STE 1000, FRANKLIN, TN 37067-1509
(615) 861-6000
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0519
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2428868
—
OH
01
—
9342121
MEDICARE OTHER
OH
Enumeration date
11/08/2006
Last updated
09/25/2018
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