Provider Demographics
NPI:1770783433
Name:SUMMIT COUNTY CHILDREN SERVICES BOARD
Entity type:Organization
Organization Name:SUMMIT COUNTY CHILDREN SERVICES BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BINNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-379-2001
Mailing Address - Street 1:264 S ARLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-1354
Mailing Address - Country:US
Mailing Address - Phone:330-379-2001
Mailing Address - Fax:330-375-1313
Practice Address - Street 1:966 CLARK ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-1347
Practice Address - Country:US
Practice Address - Phone:330-379-1824
Practice Address - Fax:330-996-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0771197Medicaid