Healthcare Provider Details

I. General information

NPI: 1073147278
Provider Name (Legal Business Name): YOUNGSTOWN COMMUNITY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2020
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1413 BELMONT AVE
YOUNGSTOWN OH
44504-1105
US

IV. Provider business mailing address

1413 BELMONT AVE
YOUNGSTOWN OH
44504-1105
US

V. Phone/Fax

Practice location:
  • Phone: 646-431-5544
  • Fax:
Mailing address:
  • Phone: 646-431-5544
  • 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: JESSIE FRANCES AKPADOCK
Title or Position: PROGRAM DIRECTOR
Credential: MBA, MPH
Phone: 646-431-5544