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General NPI Number Information
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NPI Number | 1457322448
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Entity Type | Organization
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Legal Business Name | BURDMAN GROUP, INC.
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 3120 W MARKET ST
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City | WARREN
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State | OH
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Zip | 44485-3069
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Country | US
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Telephone | 330-898-6692
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Fax |
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Provider Business Mailing Address
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Address Line | 284 BROADWAY AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44504-1752
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Country | US
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Telephone | 330-743-9275
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Fax | 330-743-6110
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Authorized Official
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Title or Position | CONTROLLER
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Name | MARK WINGERT
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Credential |
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Telephone | 330-743-9275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 0605
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 04-1822
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License Number State | OH
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