| Empowered For Excellence Behavioral Health Ohio | |
|
3170 W Central Ave Ste B Toledo OH 43606-2945 | |
| (567) 316-7253 | |
| Not Available |
| Full Name | Empowered For Excellence Behavioral Health Ohio |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3170 W Central Ave Ste B, Toledo, Ohio |
| Authorized Official Name and Position | Jonathan James (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5673167253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered For Excellence Behavioral Health Ohio 3170 W Central Ave Ste B Toledo OH 43606-2945 Ph: (567) 316-7253 | Empowered For Excellence Behavioral Health Ohio 3170 W Central Ave Ste B Toledo OH 43606-2945 Ph: (567) 316-7253 |
| NPI Number | 1336538206 |
|---|---|
| Provider Enumeration Date | 01/15/2015 |
| Last Update Date | 01/03/2019 |
| Medicare PECOS PAC ID | 7911257415 |
|---|---|
| Medicare Enrollment ID | O20230905003884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336538206 | NPI | - | NPPES |
| 01-7525 | Other | OH | OHIO MENTAL HEALTH & ADDICTION SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01-7525 (Ohio) | Primary |
| Provider Name | Lucia Coleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043339047 PECOS PAC ID: 7810032265 Enrollment ID: I20100310000032 |
| Provider Name | Kristin Holder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841708021 PECOS PAC ID: 7315282191 Enrollment ID: I20181226000619 |
| Provider Name | Michele Bryant |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073062758 PECOS PAC ID: 4789047911 Enrollment ID: I20240401000368 |
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