Healthcare Provider Details

I. General information

NPI: 1124057914
Provider Name (Legal Business Name): VILLAGE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NOBLE DR
WOOSTER OH
44691-5353
US

IV. Provider business mailing address

2000 NOBLE DR
WOOSTER OH
44691-5353
US

V. Phone/Fax

Practice location:
  • Phone: 330-264-3232
  • Fax: 330-202-3880
Mailing address:
  • Phone: 330-264-3232
  • Fax: 330-202-3880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number0342
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number0342
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number0342
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number13684
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number13685
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number13686
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number0342
License Number StateOH

VIII. Authorized Official

Name: CHERYL S RODMAN
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 330-439-8492