Healthcare Provider Details

I. General information

NPI: 1588467708
Provider Name (Legal Business Name): MCH HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 5TH AVE STE 322
YOUNGSTOWN OH
44504-1765
US

IV. Provider business mailing address

681 WYNDCLIFT CIR
YOUNGSTOWN OH
44515-4368
US

V. Phone/Fax

Practice location:
  • Phone: 330-774-4440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MIQUITA C HOSEY
Title or Position: OWNER
Credential: PA-C
Phone: 330-774-4405