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General NPI Number Information
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NPI Number | 1598480097
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Entity Type | Individual
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Provider Name | ALEXANDER ELIAS
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Gender | Male
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 10/06/2022
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Provider Practice Location Address
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Address Line | 3395 WHITE BEECH LN
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-2539
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Country | US
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Telephone | 330-233-3377
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Fax |
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Provider Business Mailing Address
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Address Line | 250 SOUTHVIEW RD
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City | CANFIELD
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State | OH
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Zip | 44406-1162
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Country | US
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Telephone | 330-233-3377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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