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General NPI Number Information
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NPI Number | 1124434378
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Entity Type | Organization
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Legal Business Name | THE VILLAGE NETWORK
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 3011 AKRON RD
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City | WOOSTER
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State | OH
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Zip | 44691-7904
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Country | US
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Telephone | 330-202-3875
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 518
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City | SMITHVILLE
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State | OH
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Zip | 44677-0518
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MICHAEL SOMMERS
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Credential | LPCC S
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Telephone | 330-202-3875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | E0500613. SUPV
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License Number State | OH
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