Provider Demographics
NPI:1023380102
Name:OHIO NORTH EAST HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:OHIO NORTH EAST HEALTH SYSTEMS INC
Other - Org Name:ACT CENTER FOR RECOVERY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:DWINNELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-747-9551
Mailing Address - Street 1:726 WICK AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-2827
Mailing Address - Country:US
Mailing Address - Phone:330-747-9551
Mailing Address - Fax:330-884-6120
Practice Address - Street 1:1032 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6602
Practice Address - Country:US
Practice Address - Phone:330-747-9551
Practice Address - Fax:330-884-6120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0061741Medicaid
OHSA4269162Medicare UPIN
OH0623169Medicaid
OH000000166224OtherANTHEM
OH4269162Medicare PIN
OH000000163381OtherUHC COMMUNITY PLAN
OH341517095027OtherCARESOURCE
OHJ53630OtherSUMMA CARE
OH2874180Medicaid
OH4269161Medicare PIN
OH0879141Medicare Oscar/Certification
OH341517095001OtherMEDICAL MUTUAL
OHSA4269161Medicare PIN