ADDICTION OUTREACH CLINIC LTD NPI 1356612261

NPI Information

ADDICTION OUTREACH CLINIC LTD is an addiction medicine psychiatry neurology in Boardman, OH. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine ADDICTION OUTREACH CLINIC LTD NPI is 1356612261. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

819 MCKAY CT STE 102
BOARDMAN, OH
ZIP 44512-771
Phone: (330) 259-4849
Fax: (330) 629-2847

The provider's authorized official is Nicholas Anthony Atanasoff .
The authorized official title is Medical Director and has the following contact phone number (330) 259-4849.

The CLIA number assigned to this NPI record is 36D2033023 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2012 and was last updated on 11/7/2023.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.