Organization
STATE OF OHIO DEPARTMENT OF MENTAL HEALTH
Active
Other names
SB - Summit Behavioral Health 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
1101 SUMMIT RD, CINCINNATI, OH 45237-2621
(513) 948-3600
(513) 948-3080
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
—
10343
MACSIS
OH
05
—
2589293
—
OH
Enumeration date
03/16/2006
Last updated
01/29/2008
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