Provider Demographics
NPI:1740672633
Name:THE VILLAGE NETWORK
Entity type:Organization
Organization Name:THE VILLAGE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:EVE
Authorized Official - Middle Name:
Authorized Official - Last Name:GELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-526-0204
Mailing Address - Street 1:107 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8786
Mailing Address - Country:US
Mailing Address - Phone:740-827-6811
Mailing Address - Fax:
Practice Address - Street 1:107 PLAZA DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-8786
Practice Address - Country:US
Practice Address - Phone:740-827-6811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1500041251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health