| Sub Provider Psych | |
|
3130 N County Road 25a Troy OH 45373-1337 | |
| (937) 440-4000 | |
| (937) 440-7882 |
| Full Name | Sub Provider Psych |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 3130 N County Road 25a, Troy, Ohio |
| Authorized Official Name and Position | Timothy D. Snider (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9374407853 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sub Provider Psych 3130 N County Road 25a Troy OH 45373-1337 Ph: (937) 440-4000 | Sub Provider Psych 3130 N County Road 25a Troy OH 45373-1337 Ph: (937) 440-4000 |
| NPI Number | 1194733121 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194733121 | NPI | - | NPPES |
| 8502258 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 052386 (Ohio) | Primary |
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