Provider Demographics
NPI:1154541167
Name:GEAUGA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:GEAUGA HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SECOY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-729-0612
Mailing Address - Street 1:8389 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-2565
Mailing Address - Country:US
Mailing Address - Phone:440-729-0612
Mailing Address - Fax:
Practice Address - Street 1:8389 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-2565
Practice Address - Country:US
Practice Address - Phone:440-729-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0004329652OtherAETNA
OH44-00302OtherUNITED HEALTH CARE
OH000000139586OtherANTHEM
OH604052OtherACN
OH000000139586OtherANTHEM
OH604052OtherACN
OH604052OtherACN