| Aja Behavioral | |
|
1115-1 N Shoop Ave Wauseon OH 43567-1857 | |
| (419) 335-6122 | |
| (419) 318-4157 |
| Full Name | Aja Behavioral |
|---|---|
| Speciality | Social Worker |
| Location | 1115-1 N Shoop Ave, Wauseon, Ohio |
| Authorized Official Name and Position | Antonia Gracia Grimolizzi-jensen (OWNER) |
| Authorized Official Contact | 4193356122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aja Behavioral P.o. Box 146 Wauseon OH 43567-0146 Ph: (419) 335-6122 | Aja Behavioral 1115-1 N Shoop Ave Wauseon OH 43567-1857 Ph: (419) 335-6122 |
| NPI Number | 1093772733 |
|---|---|
| Provider Enumeration Date | 04/27/2006 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Medicare PECOS PAC ID | 0042281537 |
|---|---|
| Medicare Enrollment ID | O20040805001661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093772733 | NPI | - | NPPES |
| 282524354005 | Other | OH | MEDICAL MUTUAL |
| 000000371817 | Other | OH | ANTHEM BC & BS |
| 716572000 | Other | OH | MAGELLAN HEALTH SERVICES |
| Provider Name | Antonia G Grimolizzi Jensen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962577510 PECOS PAC ID: 8022089515 Enrollment ID: I20040809001466 |
| Provider Name | Laura M Limpert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306139076 PECOS PAC ID: 4981843984 Enrollment ID: I20130625000040 |
| Provider Name | Tess Homier Salisbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366830911 PECOS PAC ID: 0941586663 Enrollment ID: I20211213001604 |
Family Services Of Northwest Ohio Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7320 State Highway 108 Ste A, Wauseon, OH 43567 Phone: 419-335-3732 Fax: 419-335-3462 | |
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Family Service Of Northwest Ohio Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7320 State Highway 108, Suite A, Wauseon, OH 43567 Phone: 419-335-3732 Fax: 419-335-3462 |