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General NPI Number Information
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NPI Number | 1639146574
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Entity Type | Organization
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Legal Business Name | NORTH CANTON PLAYHOUSE SPOTLIGHT ON YOUTH
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1127 E MAPLE ST
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City | NORTH CANTON
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State | OH
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Zip | 44720-2678
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Country | US
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Telephone | 330-494-3423
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 E MAPLE ST
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City | NORTH CANTON
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State | OH
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Zip | 44720-2678
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Country | US
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Telephone | 330-494-3423
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ERA LYNN TRIPP
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Credential | ED
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Telephone | 330-494-3423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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