| NPI | 1063479079 |
|---|---|
| Former Legal Business Name | MOUNDBUILDERS GUIDANCE CENTER |
| Entity Type | Organization |
| Authorized Contact | LEE RENNER Billing Supervisor 740-788-0236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.037464) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2017-05-09 |