RAVENWOOD MENTAL HEALTH CENTER NPI 1932666740

NPI Information

RAVENWOOD MENTAL HEALTH CENTER is a general practice in Chardon, OH. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee RAVENWOOD MENTAL HEALTH CENTER NPI is 1932666740. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12557 RAVENWOOD DR
CHARDON, OH
ZIP 44024-009
Phone: (440) 285-3568

The provider's authorized official is Vicki Clark .
The authorized official title is President And Ceo and has the following contact phone number (440) 285-2170.

The CLIA number assigned to this NPI record is 36D1099312 - other - mental health/dual dx with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2019 and was last updated on 2/28/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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