| Caregiver Grove Behavioral Health Llc | |
|
3950 Sunforest Ct Ste 207 Toledo OH 43623-4522 | |
| (419) 720-6811 | |
| (419) 754-2271 |
| Full Name | Caregiver Grove Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3950 Sunforest Ct Ste 207, Toledo, Ohio |
| Authorized Official Name and Position | Chass Rice (VICE PRESIDENT) |
| Authorized Official Contact | 4193405137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caregiver Grove Behavioral Health Llc 3950 Sunforest Ct Ste 207 Toledo OH 43623-4522 Ph: (419) 720-6811 | Caregiver Grove Behavioral Health Llc 3950 Sunforest Ct Ste 207 Toledo OH 43623-4522 Ph: (419) 720-6811 |
| NPI Number | 1821525841 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 05/16/2024 |
| Certification Date | 05/16/2024 |
| Medicare PECOS PAC ID | 4789011552 |
|---|---|
| Medicare Enrollment ID | O20200218000796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821525841 | NPI | - | NPPES |
| 0224458 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Alamdar Kazmi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457361768 PECOS PAC ID: 5698663847 Enrollment ID: I20040309000424 |
| Provider Name | June Annette Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932384187 PECOS PAC ID: 6406280064 Enrollment ID: I20200107002513 |
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