Provider Demographics
NPI:1336543883
Name:THE VILLAGE NETWORK
Entity Type:Organization
Organization Name:THE VILLAGE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-782-0092
Mailing Address - Street 1:40060 NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:OH
Mailing Address - Zip Code:43719-9763
Mailing Address - Country:US
Mailing Address - Phone:740-782-0092
Mailing Address - Fax:
Practice Address - Street 1:40060 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:OH
Practice Address - Zip Code:43719-9763
Practice Address - Country:US
Practice Address - Phone:740-782-0092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH330395323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility