| Monarch Grief Center | |
|
314 Louisiana Ave Perrysburg OH 43551-1461 | |
| (567) 331-8601 | |
| Not Available |
| Full Name | Monarch Grief Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 314 Louisiana Ave, Perrysburg, Ohio |
| Authorized Official Name and Position | Timothy Polakowski (COFOUNDER & EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5673318601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monarch Grief Center 314 Louisiana Ave Perrysburg OH 43551-1461 Ph: (567) 331-8601 | Monarch Grief Center 314 Louisiana Ave Perrysburg OH 43551-1461 Ph: (567) 331-8601 |
| NPI Number | 1073293569 |
|---|---|
| Provider Enumeration Date | 07/20/2023 |
| Last Update Date | 07/20/2023 |
| Certification Date | 07/20/2023 |
| Medicare PECOS PAC ID | 1254795909 |
|---|---|
| Medicare Enrollment ID | O20230913002160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073293569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Timothy Polakowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871273276 PECOS PAC ID: 3779947395 Enrollment ID: I20230915001309 |
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