Healthcare Provider Details

I. General information

NPI: 1235451477
Provider Name (Legal Business Name): 4KIDHELP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2010
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4368 DRESSLER RD NW STE 103
CANTON OH
44718-2776
US

IV. Provider business mailing address

4368 DRESSLER RD NW STE 103
CANTON OH
44718-2776
US

V. Phone/Fax

Practice location:
  • Phone: 330-433-1300
  • Fax: 330-494-0828
Mailing address:
  • Phone: 330-433-1300
  • Fax: 330-494-0828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LEHMAN REYNOLDS
Title or Position: OWNER
Credential: MD
Phone: 330-433-1300