Healthcare Provider Details

I. General information

NPI: 1699037531
Provider Name (Legal Business Name): AKRON COMMUNITY DEVELOPMENT ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1293 COPLEY RD
AKRON OH
44320-2766
US

IV. Provider business mailing address

1293 COPLEY RD
AKRON OH
44320-2766
US

V. Phone/Fax

Practice location:
  • Phone: 330-374-1199
  • Fax: 330-374-0151
Mailing address:
  • Phone: 330-374-1199
  • Fax: 330-374-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0661
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY A. DENNIS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 330-374-1199