Organization · Type 2 NPI

Mental Health and Additive Services

Substance Abuse Rehabilitation Facility · Sugar Grove, OH

NPI number 1780133504 Active

Practice location

RR 1 Box 549
Sugar Grove, OH 43155-9627

Call (740) 653-4324 Map

Mailing address

5900 Bis Rd SW
Lancaster, OH 43130-9606

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	PCC-SE177 (OH)

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

NPI record

NPI: 1780133504
Entity type: Organization (Type 2)
Issued: Sep 22, 2016
Last updated: Sep 22, 2016
Status: Active
Subpart: Yes of Southeastern Correctional

Other names

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Southeastrn Correctional · other name

Authorized official

Mr. Richard G Gettings, LPCC-S
Correctiional Program Coornator
(740) 653-4324

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780133504

Mental Health and Additive Services's National Provider Identifier is 1780133504, issued on Sep 22, 2016. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Sugar Grove, OH. The record was last updated on Sep 22, 2016.