| Rocking Horse Center | |
|
212 N Main St London OH 43140-1115 | |
| (740) 845-7286 | |
| (740) 845-7499 |
| Full Name | Rocking Horse Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 212 N Main St, London, Ohio |
| Authorized Official Name and Position | Shonda E Wallace (CFO) |
| Authorized Official Contact | 9373241111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocking Horse Center 651 S Limestone St Springfield OH 45505-1965 Ph: (937) 324-1111 | Rocking Horse Center 212 N Main St London OH 43140-1115 Ph: (740) 845-7286 |
| NPI Number | 1396299004 |
|---|---|
| Provider Enumeration Date | 08/10/2016 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396299004 | NPI | - | NPPES |
| 0184083 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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State Of Ohio Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1580 State Route 56 Sw, London Correctional Institution, London, OH 43140 Phone: 740-852-2454 |