| Full Name | |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 1502 Canton Rd, Akron, Ohio |
| Authorized Official Name and Position | Alejandra Vilchis (CREDENTILAING PROVIDER DATA MANAGER) |
| Authorized Official Contact | 4809771438 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8444 N 90th St Ste 100 Scottsdale AZ 85258-4437 Ph: (602) 248-8886 | 1502 Canton Rd Akron OH 44312-4043 Ph: (602) 248-8886 |
| NPI Number | 1750147468 |
|---|---|
| Provider Enumeration Date | 02/21/2024 |
| Last Update Date | 05/22/2024 |
| Certification Date | 05/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750147468 | NPI | - | NPPES |
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