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1433 5th St Nw New Philadelphia OH 44663-1223 | |
| (330) 343-8171 | |
| (330) 343-8439 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1433 5th St Nw, New Philadelphia, Ohio |
| Authorized Official Name and Position | Marilyn L. Henry (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3303438171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1433 5th St Nw New Philadelphia OH 44663-1223 Ph: (330) 343-8171 | 1433 5th St Nw New Philadelphia OH 44663-1223 Ph: (330) 343-8171 |
| NPI Number | 1134203995 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134203995 | NPI | - | NPPES |
| 0200795 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 170 (Ohio) | Primary |
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