Provider Demographics
NPI:1770274862
Name:EARLY START BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:EARLY START BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALEXICIA
Authorized Official - Middle Name:CIERA
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-720-5554
Mailing Address - Street 1:2857 AIRPORT HWY STE G
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-1579
Mailing Address - Country:US
Mailing Address - Phone:567-322-0443
Mailing Address - Fax:
Practice Address - Street 1:2857 AIRPORT HWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-1545
Practice Address - Country:US
Practice Address - Phone:567-322-0443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health