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COUNTY OF LAKE COURT HOUSE

Ambulatory Health Care Facilities Clinic/Center Public Health, State or Local

Provider NPI: 1598826216

Organization Information:
Organization Name:  COUNTY OF LAKE COURT HOUSE
Organization is not Subpart
Authorized Official:  RON  GRAHAM  HEALTH COMISSIONER  440-350-2554

Practice Location:
5966 HEISLEY RD  MENTOR, OH 44060-1886 US
Tel: 440-350-2554  Fax: 440-350-2956

Business Mailing Address:
5966 HEISLEY RD  MENTOR, OH 44060-1886 US
Tel: 440-350-2554  Fax: 440-350-2956

NPI Information:
NPI: 1598826216
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y261QP0905XAmbulatory Health Care Facilities
Clinic/Center
Public Health, State or Local

Other Provider Identifiers:

IssuerNumberStateType
0567480OH05



American Medical Association 2012 taxonomy code information

Code: 261QP0905X

Type:

Classification:



Definition:



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