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625 Garfield Ave Lancaster OH 43130-2432 | |
| (740) 201-2778 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 625 Garfield Ave, Lancaster, Ohio |
| Authorized Official Name and Position | Burbridge B Cook (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7402012778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
625 Garfield Ave Lancaster OH 43130-2432 Ph: (740) 201-2778 | 625 Garfield Ave Lancaster OH 43130-2432 Ph: (740) 201-2778 |
| NPI Number | 1578345781 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 12/08/2023 |
| Certification Date | 12/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578345781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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