Basic Information
| Provider Information | |||||||||
| NPI: | 1528533320 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHIO TREATMENT CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6185 PASEO DEL NORTE, STE 150 | ||||||||
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| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552592288 | ||||||||
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| Practice Location | |||||||||
| Address1: | 475 LEXINGTON AVE. | ||||||||
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| City: | MANSFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552592288 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2018 | ||||||||
| LastUpdateDate: | 10/08/2018 | ||||||||
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| AuthorizedOfficialLastName: | MORRIS | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CTC DIVISION PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8552592288 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ACADIA HEALTHCARE COMPANY, INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | Y | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic |
No ID Information.