Healthcare Provider Details

I. General information

NPI: 1487471363
Provider Name (Legal Business Name): ENOUGHCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 WERTZ AVE NW
CANTON OH
44708-4171
US

IV. Provider business mailing address

131 WERTZ AVE NW
CANTON OH
44708-4171
US

V. Phone/Fax

Practice location:
  • Phone: 214-234-8470
  • Fax: 214-234-8471
Mailing address:
  • Phone: 330-256-8847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLEY ROSS-HOPKINS
Title or Position: CPO CHIEF PARTNERSHIP OFFICER
Credential: LCDCIII121033
Phone: 330-256-8847