| Land Of Goshen Treatment Center, Inc | |
|
81 Township Road 349 Ironton OH 45638-8617 | |
| (740) 449-7875 | |
| Not Available |
| Full Name | Land Of Goshen Treatment Center, Inc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 81 Township Road 349, Ironton, Ohio |
| Authorized Official Name and Position | Amy Smith (PROGRAM DIRECTOR) |
| Authorized Official Contact | 7404427875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Land Of Goshen Treatment Center, Inc 81 Township Road 349 Ironton OH 45638-8617 Ph: (740) 449-7875 | Land Of Goshen Treatment Center, Inc 81 Township Road 349 Ironton OH 45638-8617 Ph: (740) 449-7875 |
| NPI Number | 1568822633 |
|---|---|
| Provider Enumeration Date | 03/02/2016 |
| Last Update Date | 10/19/2021 |
| Certification Date | 10/19/2021 |
| Medicare PECOS PAC ID | 9234463563 |
|---|---|
| Medicare Enrollment ID | O20190620001422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568822633 | NPI | - | NPPES |
| 0164622 | Medicaid | OH |
| Provider Name | Amy Lynn Salyers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083805899 PECOS PAC ID: 5799879714 Enrollment ID: I20240319002311 |
| Provider Name | Mark W. Salyers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508267071 PECOS PAC ID: 7719201912 Enrollment ID: I20240415003056 |
Land Of Goshen Treatment Center, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 81 Township Road 349, Ironton, OH 45638 Phone: 740-442-7758 | |
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