Organization
MENTAL HEALTH SERVICES FOR CLARK CO INC
Active
Other names
Mental Health Services for Clark and Madison Counties, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY L RIGGER (CEO)
(937) 399-9500
Entity
Organization
Contact information
Practice address
474 N YELLOW SPRINGS STREET, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Mailing address
474 N YELLOW SPRINGS STREET, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006
OHIO DEPT OF MENTAL HEALT
OH
05
—
2466602
—
OH
01
—
9338511
MEDICARE
OH
Enumeration date
11/01/2005
Last updated
05/11/2021
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