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NPI Code Detail

MEDICARE: URBAN OUNCE OF PREVENTION BEHAVIORAL HEALTH SERVICES, INCORPORATED

MEDICARE: URBAN OUNCE OF PREVENTION BEHAVIORAL HEALTH SERVICES, INCORPORATED
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2343900000XNon-emergency Medical Transport (VAN)
3251S00000XCommunity/Behavioral Health Agency02292OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679690309
Entity Type Code : Organization
Provider Name (Legal Business Name) : URBAN OUNCE OF PREVENTION BEHAVIORAL HEALTH SERVICES, INCORPORATED
Provider Business Mailing Address
First Line : PO BOX 8189
Second Line :
City : AKRON
State : OH
Zip : 44320-0189
Country : US
Telephone Number : 330-867-5400
Fax Number : 330-869-8263
Provider Business Practice Location Address
First Line : 1735 S HAWKINS AVE
Second Line :
City : AKRON
State : OH
Zip : 44320-3902
Country : US
Telephone Number : 330-867-5400
Fax Number : 330-869-8263
Authorized Official
Title or Position : PRESIDENT AND CEO
Name : MRS. EVAUGHN CAGLE
Credential :
Telephone Number : 330-867-5400
Provider Enumeration Date : 03/26/2007
Last Update Date : 03/17/2023

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1932613247 — MISS MARY KENT LCDCIII, QMHS
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