Healthcare Provider Details

I. General information

NPI: 1528546470
Provider Name (Legal Business Name): BENJAMIN MESZAR CDCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N CANFIELD NILES RD
AUSTINTOWN OH
44515-2343
US

IV. Provider business mailing address

45 N CANFIELD NILES RD
AUSTINTOWN OH
44515-2343
US

V. Phone/Fax

Practice location:
  • Phone: 330-367-7411
  • Fax:
Mailing address:
  • Phone: 330-367-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number166916
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.183565
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: