MEDICARE: AKRON U.M.A.D.A.O.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	081023	OH

General Provider Information

NPI Number	:	1548715949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKRON U.M.A.D.A.O.P.

Provider Business Mailing Address
First Line	:	665 W MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44303-1438
Country	:	US
Telephone Number	:	330-379-3467
Fax Number	:	330-379-3465

Provider Business Practice Location Address
First Line	:	665 W MARKET ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44303-1438
Country	:	US
Telephone Number	:	330-379-3467
Fax Number	:	330-379-3465

Authorized Official
Title or Position	:	COUNSELOR
Name	:	MR. PRESTON BENJAMIN FLINN
Credential	:	LICDC-CS
Telephone Number	:	330-289-7173

Provider Enumeration Date	:	08/16/2016
Last Update Date	:	08/16/2016

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