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General NPI Number Information
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NPI Number | 1336014927
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Entity Type | Organization
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Legal Business Name | A.V.O BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 4105 HOLIDAY ST NW STE 202
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City | CANTON
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State | OH
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Zip | 44718-2531
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Country | US
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Telephone | 330-826-1430
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Fax |
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Provider Business Mailing Address
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Address Line | 4105 HOLIDAY ST NW STE 202
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City | CANTON
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State | OH
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Zip | 44718-2531
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Country | US
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Telephone | 330-826-1430
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | STACY STOUT
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Credential |
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Telephone | 330-331-7506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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