Organization
FAMILY GUIDANCE CENTERS OF OHIO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY IDE (MANAGED CARE SPECIALIST)
(224) 659-7030
Entity
Organization
Contact information
Practice address
4354 MONROE ST, TOLEDO, OH 43606-1959
(419) 442-7145
(419) 389-0306
Mailing address
2618 PATRIOT BLVD, GLENVIEW, IL 60026-8024
(224) 659-7030
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-7760
OHIO MENTAL HEALTH & ADDICTION SERVICES
OH
01
—
0267000018
STATE OF OHIO BOARD OF PHARMACY
OH
01
—
4154785
STATE OF OHIO CERTIFICATION SECRETARY OF STATE
OH
Enumeration date
08/08/2019
Last updated
12/13/2019
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