| Full Name | |
|---|---|
| Speciality | Counselor - Pastoral |
| Location | 1130 Market Street, Lima, Ohio |
| Authorized Official Name and Position | Thomas M Holmes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4192282070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1130 Market Street Lima OH 45805 Ph: (419) 228-2070 | 1130 Market Street Lima OH 45805 Ph: (419) 228-2070 |
| NPI Number | 1376752592 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 04/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376752592 | NPI | - | NPPES |
| 9387131 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP1600X | Counselor - Pastoral | 319211 (Ohio) | Primary |
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