=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528074366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADDICTION PROGRAMS OF MAHONING COUNTY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2516 MARKET ST
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44507-1421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-788-7977
-----------------------------------------------------
Fax | 330-788-7447
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2516 MARKET ST
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44507-1421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-788-7977
-----------------------------------------------------
Fax | 330-788-7447
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. THOMAS M VASVARI
-----------------------------------------------------
Credential | J.D.
-----------------------------------------------------
Telephone | 330-788-7977
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------