NPI 1013986082

State of Ohio Office of Budget and Management, State Accounting

Organisation Mental Illness Community Based Residential Treatment Facility Willoughby, OH

Practice location

Address: 1420 Lost Nation Rd, Willoughby, OH 44094-7375
Phone: (330) 467-7131
Fax: (330) 467-2420
Mailing address: 30 E. Broad St 11th Floor - Fiscal Administration, Columbus, OH 43215-3430

Authorised official

Name: Tonya Marie Fasone
Title: Fiscal Manager
Phone: (614) 466-9930

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Ohio →

Registry record

NPI: 1013986082
Entity type: Organization
NPI issued: 14 Mar 2006
Record last updated: 30 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.