Provider Demographics
NPI:1124388517
Name:TUSCARAWAS COUNTY AUDITOR
Entity Type:Organization
Organization Name:TUSCARAWAS COUNTY AUDITOR
Other - Org Name:ALCOHOL AND ADDICTION PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-343-4928
Mailing Address - Street 1:897 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2030
Mailing Address - Country:US
Mailing Address - Phone:330-343-5555
Mailing Address - Fax:330-364-8946
Practice Address - Street 1:897 E IRON AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2030
Practice Address - Country:US
Practice Address - Phone:330-343-5555
Practice Address - Fax:330-364-8946
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUSCARAWAS COUNTY AUDITOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1520251S00000X
OH1556251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1556OtherOHIO DEPARTMENT OF ALCOHOL AND DRUG ADDICTION SERVICES
OH1520OtherOHIO DEPARTMENT OF ALCOHOL AND DRUG ADDICTION SERVICES