| Organization Name: | SHAWNEE MENTAL HEALTH CENTER, INC. |
| NPI Number: | 1164794160 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DON THACKER (EXECUTIVE DIRECTOR) |
| Mailing Address: | 715 Lane St Coal Grove |
| State: | OH US |
| Postal Code: | 456383161 |
| Phone Number: | 7405336206 |
| Fax Number: | 7405336284 |
| NPI Enumeration Date: | 02/07/2012 |
| NPI Last Update Date: | 02/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |