| Moving Forward Residential Llc | |
|
7175 State Route 104 Mc Dermott OH 45652-8888 | |
| (740) 858-6683 | |
| Not Available |
| Full Name | Moving Forward Residential Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7175 State Route 104, Mc Dermott, Ohio |
| Authorized Official Name and Position | Michele Lawson (OWNER) |
| Authorized Official Contact | 7403571937 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moving Forward Residential Llc Po Box 402 Wheelersburg OH 45694-0402 Ph: (740) 357-1937 | Moving Forward Residential Llc 7175 State Route 104 Mc Dermott OH 45652-8888 Ph: (740) 858-6683 |
| NPI Number | 1871016691 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 04/16/2026 |
| Certification Date | 04/16/2026 |
| Medicare PECOS PAC ID | 0941722573 |
|---|---|
| Medicare Enrollment ID | O20250324001525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871016691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
| Provider Name | Keith Frazier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588027593 PECOS PAC ID: 5890075196 Enrollment ID: I20161202000535 |
Moving Forward Residential Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9620 Careys Run Pond Creek Rd, Mc Dermott, OH 45652 Phone: 740-858-6683 |