| Philio, Inc. | |
|
111 S Byrne Rd Toledo OH 43615-6212 | |
| (419) 531-5544 | |
| (419) 531-5117 |
| Full Name | Philio, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 111 S Byrne Rd, Toledo, Ohio |
| Authorized Official Name and Position | Janice R Edwards (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4195315544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philio, Inc. Po Box 20068 Toledo OH 43610-0068 Ph: (419) 531-5544 | Philio, Inc. 111 S Byrne Rd Toledo OH 43615-6212 Ph: (419) 531-5544 |
| NPI Number | 1124367545 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 12/18/2020 |
| Certification Date | 12/18/2020 |
| Medicare PECOS PAC ID | 5395895437 |
|---|---|
| Medicare Enrollment ID | O20170814001182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124367545 | NPI | - | NPPES |
| 2901122 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0696 (Ohio) | Primary |
| Provider Name | Lurley J Archambeau |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1376529768 PECOS PAC ID: 3779507124 Enrollment ID: I20061005000606 |
| Provider Name | Jay L Smith |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1124079009 PECOS PAC ID: 2466417118 Enrollment ID: I20071218000244 |
| Provider Name | Lashanna D Alfred |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669889333 PECOS PAC ID: 5395017214 Enrollment ID: I20170828000365 |
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