Provider Demographics
NPI:1215961594
Name:APPLESEED COMMUNITY MENTAL HEALTH CENTER INC
Entity type:Organization
Organization Name:APPLESEED COMMUNITY MENTAL HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-281-3716
Mailing Address - Street 1:2233 ROCKY LANE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-4701
Mailing Address - Country:US
Mailing Address - Phone:419-281-3716
Mailing Address - Fax:419-281-4605
Practice Address - Street 1:2233 ROCKY LN
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4701
Practice Address - Country:US
Practice Address - Phone:419-281-3716
Practice Address - Fax:419-281-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0002261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0201883Medicaid
OH9263731Medicare PIN
OH0201883Medicaid