Provider Demographics
NPI:1316112832
Name:HANCOCK COUNTY MENTAL HEALTH ASSOCIATES, LLC
Entity type:Organization
Organization Name:HANCOCK COUNTY MENTAL HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-332-7321
Mailing Address - Street 1:1100 E MAIN CROSS ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6381
Mailing Address - Country:US
Mailing Address - Phone:419-424-1471
Mailing Address - Fax:419-424-1413
Practice Address - Street 1:1100 E MAIN CROSS ST
Practice Address - Street 2:SUITE 203
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6381
Practice Address - Country:US
Practice Address - Phone:419-424-1471
Practice Address - Fax:419-424-1413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH38439261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)