| Townhall Ii Inc. | |
|
155 N Water St Kent OH 44240-2418 | |
| (330) 678-3006 | |
| (330) 677-7047 |
| Full Name | Townhall Ii Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 155 N Water St, Kent, Ohio |
| Authorized Official Name and Position | Sue E Whitehurst (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3303783006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Townhall Ii Inc. 155 N Water St Kent OH 44240-2418 Ph: (330) 678-3006 | Townhall Ii Inc. 155 N Water St Kent OH 44240-2418 Ph: (330) 678-3006 |
| NPI Number | 1407808827 |
|---|---|
| Provider Enumeration Date | 05/16/2006 |
| Last Update Date | 06/17/2009 |
| Medicare PECOS PAC ID | 0749330538 |
|---|---|
| Medicare Enrollment ID | O20160615001947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407808827 | NPI | - | NPPES |
| Provider Name | Dean J Deperro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568567410 PECOS PAC ID: 1355399254 Enrollment ID: I20050107000134 |
| Provider Name | Lateace Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245558634 PECOS PAC ID: 6406123850 Enrollment ID: I20170606002547 |
| Provider Name | Christopher Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700319498 PECOS PAC ID: 5193187011 Enrollment ID: I20230809002458 |
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