Basic Information
| Provider Information | |||||||||
| NPI: | 1144755406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MENTAL CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8440 | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436230440 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5842 APPLE MEADOW DR | ||||||||
| Address2: | |||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435604507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4198850200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2017 | ||||||||
| LastUpdateDate: | 04/25/2017 | ||||||||
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| AuthorizedOfficialLastName: | SADEHH | ||||||||
| AuthorizedOfficialFirstName: | ABDULMALEK | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4198850200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 35.125820 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.