Provider Demographics
NPI:1043340946
Name:THE NORTH COAST CENTER
Entity Type:Organization
Organization Name:THE NORTH COAST CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHOURE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-992-8552
Mailing Address - Street 1:2250 PAR LN
Mailing Address - Street 2:APT # 723
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-2921
Mailing Address - Country:US
Mailing Address - Phone:440-516-1434
Mailing Address - Fax:
Practice Address - Street 1:4200 PARK AVE
Practice Address - Street 2:THE NORTH COAST CENTER
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004
Practice Address - Country:US
Practice Address - Phone:440-992-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85719251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health