Healthcare Provider Details

I. General information

NPI: 1649866955
Provider Name (Legal Business Name): NOT AN ORDINARY PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S WALNUT ST
DUNKIRK OH
45836-1114
US

IV. Provider business mailing address

240 S WALNUT ST
DUNKIRK OH
45836-1114
US

V. Phone/Fax

Practice location:
  • Phone: 567-229-4028
  • Fax:
Mailing address:
  • Phone: 567-229-4028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BETH BELL
Title or Position: CEO
Credential:
Phone: 419-348-5978