Basic Information
| Provider Information | |||||||||
| NPI: | 1407114531 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MAUMEE VALLEY GUIDANCE CENTER,INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MAUMEE VALLEY GUIDANCE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 BIEDE AVE | ||||||||
| Address2: | |||||||||
| City: | DEFIANCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435122408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197828856 | ||||||||
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| Practice Location | |||||||||
| Address1: | 211 BIEDE AVE | ||||||||
| Address2: | |||||||||
| City: | DEFIANCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197828856 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2012 | ||||||||
| LastUpdateDate: | 06/04/2018 | ||||||||
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| AuthorizedOfficialLastName: | PLANSON | ||||||||
| AuthorizedOfficialFirstName: | CONNIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 4197828856 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.