Provider Demographics
NPI: | 1568136158 |
---|---|
Name: | MAHONING COUNTY COMMUNITY CORRECTIONS ASSOCIATION, INC. |
Entity Type: | Organization |
Organization Name: | MAHONING COUNTY COMMUNITY CORRECTIONS ASSOCIATION, INC. |
Other - Org Name: | COMMUNITY CORRECTIONS ASSOCIATION, INC. |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ANGELA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | NEELY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 330-744-5143 |
Mailing Address - Street 1: | 1507 MARKET ST |
Mailing Address - Street 2: | |
Mailing Address - City: | YOUNGSTOWN |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44507-1127 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 330-744-5143 |
Mailing Address - Fax: | 330-742-8661 |
Practice Address - Street 1: | 1771 MARKET ST |
Practice Address - Street 2: | |
Practice Address - City: | YOUNGSTOWN |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44507-1135 |
Practice Address - Country: | US |
Practice Address - Phone: | 330-744-5143 |
Practice Address - Fax: | 330-742-8661 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-08-06 |
Last Update Date: | 2023-07-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |