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YOUNGSTOWN COMMITTEE ON ALCOHOLISM INC NPI 1033111406


NPI Information

NPI: 1033111406
Provider Name: YOUNGSTOWN COMMITTEE ON ALCOHOLISM INC

Doing Business As: NEIL KENNEDY RECOVERY CENTERS

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 36D1005240

Address:
2151 RUSH BLVD
YOUNGSTOWN, OH
ZIP 44507
Phone: (330) 744-1181
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YOUNGSTOWN COMMITTEE ON ALCOHOLISM INC is a substance abuse rehabilitation facility in Youngstown, OH. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. YOUNGSTOWN COMMITTEE ON ALCOHOLISM INC NPI is 1033111406. The provider is registered as an organization entity type.
The provider Is Doing Business As Neil Kennedy Recovery Centers.

The provider's business location address is:

2151 RUSH BLVD
YOUNGSTOWN, OH
ZIP 44507-535
Phone: (330) 744-1181
Fax: (330) 740-2849

The provider's authorized official is James Troup .
The authorized official title is President/ceo and has the following contact phone number (412) 604-8900.

The CLIA number assigned to this NPI record is 36D1005240 - other - drug/alcohol treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 6/3/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use Disorder01365OHIONo
2324500000XSubstance Abuse Rehabilitation Facility01365OHIONo
3324500000XSubstance Abuse Rehabilitation FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101-7688OTHEROHIOFACILITY LICENSE
22877507MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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