Provider Demographics
NPI:1992898829
Name:RESOURCES FOR HEALTHY LIVING INC
Entity type:Organization
Organization Name:RESOURCES FOR HEALTHY LIVING INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MARCIA WARD PHD
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-874-9488
Mailing Address - Street 1:330 LOUSIANA AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551
Mailing Address - Country:US
Mailing Address - Phone:419-874-9488
Mailing Address - Fax:419-874-4822
Practice Address - Street 1:330 LOUSIANA AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551
Practice Address - Country:US
Practice Address - Phone:419-874-9488
Practice Address - Fax:419-874-4822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5761103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000485219OtherANTHEM
OHL2274560Medicaid
277588371009OtherMED MUTUAL
OHL2274560Medicaid
277588371009OtherMED MUTUAL
OHCP25251Medicare ID - Type Unspecified