Provider Demographics
NPI:1710318282
Name:URSULINE CENTER
Entity Type:Organization
Organization Name:URSULINE CENTER
Other - Org Name:COMPREHENSIVE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIGID
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-792-7636
Mailing Address - Street 1:4250 SHIELDS RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406
Mailing Address - Country:US
Mailing Address - Phone:330-792-7636
Mailing Address - Fax:
Practice Address - Street 1:345 OAK HILL AVE STE 200
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:330-743-7481
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URSULINE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty