Healthcare Provider Details

I. General information

NPI: 1831811520
Provider Name (Legal Business Name): BELDEN VILLAGE HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 BELDEN VILLAGE ST. NW STE LL-15
CANTON OH
44718
US

IV. Provider business mailing address

4150 BELDEN VILLAGE ST. NW STE LL-15
CANTON OH
44718
US

V. Phone/Fax

Practice location:
  • Phone: 330-268-8733
  • Fax:
Mailing address:
  • Phone: 330-268-8733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN WHITE I
Title or Position: CEO
Credential:
Phone: 330-268-8733