| Licking Memorial Behavioral Health Pataskala | |
|
1 Healthy Pl Suite 105 Pataskala OH 43062-7067 | |
| (740) 348-1930 | |
| (740) 348-1931 |
| Full Name | Licking Memorial Behavioral Health Pataskala |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1 Healthy Pl, Pataskala, Ohio |
| Authorized Official Name and Position | Robert Montagnese (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 7403484000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking Memorial Behavioral Health Pataskala 1 Healthy Pl Suite 105 Pataskala OH 43062-7067 Ph: (740) 348-1930 | Licking Memorial Behavioral Health Pataskala 1 Healthy Pl Suite 105 Pataskala OH 43062-7067 Ph: (740) 348-1930 |
| NPI Number | 1295809614 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295809614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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