Healthcare Provider Details

I. General information

NPI: 1285323667
Provider Name (Legal Business Name): THERAPEUTIC STRENGTH-BASED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 N MIDDLE ST
COLUMBIANA OH
44408-1001
US

IV. Provider business mailing address

2359 KNOLLWOOD AVE
POLAND OH
44514-1525
US

V. Phone/Fax

Practice location:
  • Phone: 330-728-3410
  • Fax: 330-632-8823
Mailing address:
  • Phone: 216-260-1405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KAREN SUE KOCIS
Title or Position: PROGRAM DIRECTOR/CO-OWNER
Credential: M.A.
Phone: 216-260-1405