MEDICARE: SUMMIT COUNTY CHILDREN SERVICES BOARD

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
1	261QD0000X	Dental Clinic/Center
2	261Q00000X	Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1770783433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT COUNTY CHILDREN SERVICES BOARD

Provider Business Mailing Address
First Line	:	264 S ARLINGTON ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-1354
Country	:	US
Telephone Number	:	330-379-2001
Fax Number	:	330-375-1313

Provider Business Practice Location Address
First Line	:	966 CLARK ST
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44306-1347
Country	:	US
Telephone Number	:	330-379-1824
Fax Number	:	330-996-1088

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MR. GARY BINNS
Credential	:
Telephone Number	:	330-379-2001

Provider Enumeration Date	:	07/20/2007
Last Update Date	:	07/20/2007

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Directions to “SUMMIT COUNTY CHILDREN SERVICES BOARD ” Practice Location

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