Healthcare Provider Details

I. General information

NPI: 1770783433
Provider Name (Legal Business Name): SUMMIT COUNTY CHILDREN SERVICES BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 CLARK ST
AKRON OH
44306-1347
US

IV. Provider business mailing address

264 S ARLINGTON ST
AKRON OH
44306-1354
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-1824
  • Fax: 330-996-1088
Mailing address:
  • Phone: 330-379-2001
  • Fax: 330-375-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY BINNS
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 330-379-2001