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NPI Code Detail

MEDICARE: RED ZONE YOUNGSTOWN LLC

MEDICARE: RED ZONE YOUNGSTOWN LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3103K00000XBehavior Analyst
4251B00000XCase Management Agency
5251S00000XCommunity/Behavioral Health Agency
61041C0700XClinical Social Worker

General Provider Information

NPI Number : 1811348444
Entity Type Code : Organization
Provider Name (Legal Business Name) : RED ZONE YOUNGSTOWN LLC
Provider Business Mailing Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-787-9180
Fax Number :
Provider Business Practice Location Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-787-9180
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. DOMINIC GUY MANCINI
Credential : MBA
Telephone Number : 330-307-3962
Provider Enumeration Date : 06/24/2016
Last Update Date : 06/17/2024

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