Healthcare Provider Details

I. General information

NPI: 1386217743
Provider Name (Legal Business Name): STARK YOUTH TECHNOLOGY CENTER CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CENTRAL PLZ S STE 200
CANTON OH
44702-1415
US

IV. Provider business mailing address

101 CENTRAL PLZ S STE 200
CANTON OH
44702-1415
US

V. Phone/Fax

Practice location:
  • Phone: 330-284-5702
  • Fax:
Mailing address:
  • Phone: 330-284-5702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL C SMITH
Title or Position: OWNER/OPERATOR
Credential:
Phone: 330-284-5702