THIRD STREET COMMUNITY CLINIC INC NPI 1720407554

NPI Information

THIRD STREET COMMUNITY CLINIC, INC is a federally qualified health center (fqhc) clinic center in Mansfield, OH. THIRD STREET COMMUNITY CLINIC, INC NPI is 1720407554. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mansfield Family Health 2.

The provider's business location address is:

270 STERKEL BLVD
SUITE A
MANSFIELD, OH
ZIP 44907-508
Phone: (419) 775-1141
Fax: (419) 525-6723

The provider's authorized official is Peggy Anderson .
The authorized official title is Ceo and has the following contact phone number (419) 526-7880.

The CLIA number assigned to this NPI record is 36D2157108 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/9/2014 and was last updated on 2/25/2022.

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:

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