Healthcare Provider Details

I. General information

NPI: 1710318282
Provider Name (Legal Business Name): URSULINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 OAK HILL AVE STE 200
YOUNGSTOWN OH
44502
US

IV. Provider business mailing address

4250 SHIELDS RD
CANFIELD OH
44406
US

V. Phone/Fax

Practice location:
  • Phone: 330-743-7853
  • Fax: 330-743-7481
Mailing address:
  • Phone: 330-792-7636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIGID KENNEDY
Title or Position: CO-EXECUTIVE DIRECTOR
Credential:
Phone: 330-792-7636