Thomas Clark, CDCA
Individual provider Active NPI Substance Abuse Rehabilitation Facility · Warrren, OH
NPI 1457891715 · NPPES record last updated Mar 6, 2017
Key facts
- NPI
- 1457891715
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Practice address
- 2737 Youngstown Warren Rd SE
Warrren, OH 44483 - Phone
- (330) 369-8022
- NPI assigned
- Mar 6, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Step Recovery of Warren LLC | Past |
Accepting new patients | |
| First Step Recovery of Warren LLC | Substance Abuse Rehabilitation Facility | Past |
Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/wecaremoreohio/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | OH | Yes |
Addresses
Primary practice location
2737 Youngstown Warren Rd SE
Warrren, OH 44483
Mailing address
2737 Youngstown Warren Rd SE
Warrren, OH 44483
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.