Basic Information
| Provider Information | |||||||||
| NPI: | 1356601892 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTURY HEALTH, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1918 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458403818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194255050 | ||||||||
| FaxNumber: | 4194208015 | ||||||||
| Practice Location | |||||||||
| Address1: | 1918 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458403818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194255050 | ||||||||
| FaxNumber: | 4194208015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2012 | ||||||||
| LastUpdateDate: | 05/17/2012 | ||||||||
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| AuthorizedOfficialLastName: | WARD | ||||||||
| AuthorizedOfficialFirstName: | TINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ACCOUNTS RECEIVABLE CLERK | ||||||||
| AuthorizedOfficialTelephone: | 4194255050 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 0108 | OH | N | Agencies | Community/Behavioral Health | 251S00000X | 1290 | OH | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 2341666 | 01 | OH | MEDICARE CROSSOVER | OTHER | 9300162 | 01 | OH | MEDICARE PTAN | OTHER | 2480846 | 05 | OH | MEDICAID |