Healthcare Provider Details

I. General information

NPI: 1447886213
Provider Name (Legal Business Name): ALLIED COMMUNITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9701 CLEVELAND AVE NW STE 154
NORTH CANTON OH
44720-9834
US

IV. Provider business mailing address

9701 CLEVELAND AVE NW STE 154
NORTH CANTON OH
44720-9834
US

V. Phone/Fax

Practice location:
  • Phone: 330-526-6645
  • Fax:
Mailing address:
  • Phone: 330-526-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J OROS
Title or Position: PRESIDENT
Credential: MD
Phone: 330-526-6445