DUSTIN JAMES PRIDEMORE CDCA NPI 1750887931

NPI Information

Dustin James Pridemore, CDCA is a substance abuse treatment and children substance abuse rehabilitation facility in Shelby, OH. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. Dustin James Pridemore, CDCA NPI is 1750887931. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2775 STATE ROUTE 39
SHELBY, OH
ZIP 44875-466
Phone: (419) 747-3322

The enumeration date for this NPI number is 4/5/2018 and was last updated on 4/5/2018.

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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