| Lucy Idol Center, Inc | |
|
435 Nicholson Rd Vermilion OH 44089-2536 | |
| (440) 967-6724 | |
| (440) 967-4495 |
| Full Name | Lucy Idol Center, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 435 Nicholson Rd, Vermilion, Ohio |
| Authorized Official Name and Position | John Tad Peck (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4409676724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucy Idol Center, Inc Po Box 162 435 Nicholson Ave Vermilion OH 44089-0162 Ph: () - | Lucy Idol Center, Inc 435 Nicholson Rd Vermilion OH 44089-2536 Ph: (440) 967-6724 |
| NPI Number | 1962477901 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 11/02/2020 |
| Certification Date | 11/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962477901 | NPI | - | NPPES |
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