Provider Demographics
NPI:1679690309
Name:URBAN OUNCE OF PREVENTION BEHAVIORAL HEALTH SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:URBAN OUNCE OF PREVENTION BEHAVIORAL HEALTH SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVAUGHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-867-5400
Mailing Address - Street 1:PO BOX 8189
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-0189
Mailing Address - Country:US
Mailing Address - Phone:330-867-5400
Mailing Address - Fax:330-869-8263
Practice Address - Street 1:1735 S HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-3902
Practice Address - Country:US
Practice Address - Phone:330-867-5400
Practice Address - Fax:330-869-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02292251S00000X
261QM0801X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0320531Medicaid
OH3112492Medicaid