Etana Behavioral Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ETANA BEHAVIORAL HEALTH

Practice address

3178 N Republic Blvd Ste 12
Toledo, OH 43615-1516

Phone

(419) 408-6229

NPI assigned

May 14, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jasmine Crenshaw

Title

Clinical Director

Phone

(419) 408-6229

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1295584274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3178 N REPUBLIC BLVD STE 12",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3178 N REPUBLIC BLVD STE 12",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151516",
            "telephone_number": "419-408-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETANA BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "CRENSHAW",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "419-408-6229"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.