Mental Health and Additive Services
Organization Active NPI Substance Abuse Rehabilitation Facility · Sugar Grove, OH
NPI 1780133504 · NPPES record last updated Sep 22, 2016
Key facts
- NPI
- 1780133504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- License
- PCC-SE177 (OH)
- Legal business name
- MENTAL HEALTH AND ADDITIVE SERVICES
- Practice address
- RR 1 Box 549
Sugar Grove, OH 43155-9627 - Phone
- (740) 653-4324
- NPI assigned
- Sep 22, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHEASTERN CORRECTIONAL
Authorized official
- Name
- Mr. Richard G Gettings, LPCC-S
- Title
- Correctiional Program Coornator
- Phone
- (740) 653-4324
Corporate family (same tax ID) 5
National Provider Directory
- Tax ID family
- Portsmouth Receiving Ho
- Part of
- Portsmouth Receiving Ho
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | PCC-SE177 | OH | Yes |
Addresses
Primary practice location
RR 1 Box 549
Sugar Grove, OH 43155-9627
Mailing address
5900 Bis Rd SW
Lancaster, OH 43130-9606
Phone (740) 653-4324
Other names
- Southeastrn Correctional
Other providers in Sugar Grove, OH
- Berne Township Clerk
- Berne Union Local School District
- Bryan Michael Bumgardner
- Sandra Lynn Crozier
- Amber Annette Dennis
- Keirstan Mirgon
- Constance Lynn Morgan
- Catherine Morris
- Outreach MRDD Services
- Cory Reid
All providers in Sugar Grove, OH · Substance Abuse Rehabilitation Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.