Provider Demographics
NPI:1407027378
Name:YOUNGSTOWN CITY HEALTH DISTRICT
Entity Type:Organization
Organization Name:YOUNGSTOWN CITY HEALTH DISTRICT
Other - Org Name:COMPREHENSIVE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:STREB-BARAN
Authorized Official - Suffix:
Authorized Official - Credentials:CLINIC DIRECTOR
Authorized Official - Phone:330-743-7853
Mailing Address - Street 1:345 OAK HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502
Mailing Address - Country:US
Mailing Address - Phone:330-743-7853
Mailing Address - Fax:
Practice Address - Street 1:345 OAK HILL AVENUE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502
Practice Address - Country:US
Practice Address - Phone:330-743-7853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUNGSTOWN CITY HEALTH DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-18
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2504070Medicaid