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General NPI Number Information
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NPI Number | 1831811520
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Entity Type | Organization
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Legal Business Name | BELDEN VILLAGE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 4150 BELDEN VILLAGE ST. NW STE LL-15
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-268-8733
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 BELDEN VILLAGE ST. NW STE LL-15
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-268-8733
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN WHITE I
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Credential |
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Telephone | 330-268-8733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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