Provider Demographics
NPI:1235194937
Name:COUNTY OF MAHONING
Entity Type:Organization
Organization Name:COUNTY OF MAHONING
Other - Org Name:MAHONING COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE/HR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:JANIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-270-2855
Mailing Address - Street 1:50 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3991
Mailing Address - Country:US
Mailing Address - Phone:330-270-2855
Mailing Address - Fax:330-270-9194
Practice Address - Street 1:50 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3991
Practice Address - Country:US
Practice Address - Phone:330-270-2855
Practice Address - Fax:330-270-9194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
600000894OtherRAILROAD MEDICARE
OH0980167Medicaid
OH0347039OtherBCMH
OH0980167Medicaid