36D2101625 CLIA NUMBER - EMPOWERED FOR EXCELLENCE BEHAVIORAL HEALTH OHIO

Laboratory Demographics

CLIA Number: 36D2101625

Facility Name: EMPOWERED FOR EXCELLENCE BEHAVIORAL HEALTH OHIO

Facility Address:
3170 W CENTRAL AVENUE SUITE B
TOLEDO, OH
ZIP 43606
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Facility Phone Number: 567 316-7253

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1104467158

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	36D2101625
LAB Type	Community Clinic
Facility Name	EMPOWERED FOR EXCELLENCE BEHAVIORAL HEALTH OHIO
Street	3170 W CENTRAL AVENUE SUITE B
City	TOLEDO
State	OH
ZIP	43606
Phone	567 316-7253
CertificateType	4
CertificateEffectiveDate	9/4/2023
CertificateExpirationDate	9/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024