Provider Demographics
NPI:1134540503
Name:THE VILLAGE NETWORK INC.
Entity type:Organization
Organization Name:THE VILLAGE NETWORK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MSW, LSW
Authorized Official - Phone:330-788-1155
Mailing Address - Street 1:5500 MARKET ST STE 106
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-2616
Mailing Address - Country:US
Mailing Address - Phone:330-788-1155
Mailing Address - Fax:330-788-1467
Practice Address - Street 1:5500 MARKET ST STE 106
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-2616
Practice Address - Country:US
Practice Address - Phone:330-788-1155
Practice Address - Fax:330-788-1467
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE VILLAGE NETWORK INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0500644320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness