Provider Demographics
NPI:1417022682
Name:COPE TREATMENT CENTERS IN
Entity Type:Organization
Organization Name:COPE TREATMENT CENTERS IN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-932-1594
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-0591
Mailing Address - Country:US
Mailing Address - Phone:330-932-1594
Mailing Address - Fax:330-368-0067
Practice Address - Street 1:15613 PINEVIEW DR STE C
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9096
Practice Address - Country:US
Practice Address - Phone:330-932-1594
Practice Address - Fax:330-368-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350511952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3007669Medicaid
OHDG1223OtherRAILROAD MEDICARE
OH0682248Medicaid
OH000000515130OtherANTHEM BC BS
OHDG1223OtherRAILROAD MEDICARE
OH9366451Medicare PIN