| Moundbuilders Guidance Center | |
|
1445 W Main St Newark OH 43055-1989 | |
| (740) 522-8477 | |
| (740) 522-2941 |
| Full Name | Moundbuilders Guidance Center |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1445 W Main St, Newark, Ohio |
| Authorized Official Name and Position | Laura L Edelblute (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 7405228477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moundbuilders Guidance Center 65 Messimer Dr Newark OH 43055-1874 Ph: (740) 522-8477 | Moundbuilders Guidance Center 1445 W Main St Newark OH 43055-1989 Ph: (740) 522-8477 |
| NPI Number | 1366684342 |
|---|---|
| Provider Enumeration Date | 04/06/2009 |
| Last Update Date | 04/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366684342 | NPI | - | NPPES |
| 0200008 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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