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NPI Code Detail

MEDICARE: RED ZONE YOUNGSTOWN LLC

MEDICARE: RED ZONE YOUNGSTOWN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management AgencyOH
2101YA0400XAddiction (Substance Use Disorder) CounselorOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184169070
Entity Type Code : Organization
Provider Name (Legal Business Name) : RED ZONE YOUNGSTOWN LLC
Provider Business Mailing Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-787-9180
Fax Number : 234-254-8890
Provider Business Practice Location Address
First Line : 14 HIGHLAND AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2321
Country : US
Telephone Number : 330-787-9180
Fax Number : 234-254-8890
Authorized Official
Title or Position : CEO
Name : MR. DOMINIC GUY MANCINI
Credential : MBA
Telephone Number : 330-307-3962
Provider Enumeration Date : 12/30/2016
Last Update Date : 06/17/2024

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Directions to “RED ZONE YOUNGSTOWN LLC ” Practice Location

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