| Moundbuilders Guidance Center, Inc. | |
|
8402 Blackjack Road Ext Mount Vernon OH 43050-9193 | |
| (740) 397-0442 | |
| (740) 392-1814 |
| Full Name | Moundbuilders Guidance Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8402 Blackjack Road Ext, Mount Vernon, Ohio |
| Authorized Official Name and Position | Patrick C Evans (CEO) |
| Authorized Official Contact | 7407883400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moundbuilders Guidance Center, Inc. 8402 Blackjack Road Ext Mount Vernon OH 43050-9193 Ph: (740) 397-0442 | Moundbuilders Guidance Center, Inc. 8402 Blackjack Road Ext Mount Vernon OH 43050-9193 Ph: (740) 397-0442 |
| NPI Number | 1598723728 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 05/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598723728 | NPI | - | NPPES |
| 2485734 | Other | OH | RISPERDAL |
| MC-26 | Medicaid | OH | |
| 0200008 | Other | OH | MEDICARE CROSSOVER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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