| Lake County Sheriffs Office Jail Treatment Program | |
|
104 East Erie Street Suite 320 Painesville OH 44077-3910 | |
| (440) 350-5669 | |
| (440) 350-5668 |
| Full Name | Lake County Sheriffs Office Jail Treatment Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 104 East Erie Street, Painesville, Ohio |
| Authorized Official Name and Position | Lawrence Smith (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4403505669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County Sheriffs Office Jail Treatment Program 104 East Erie Street Lake County Sheriffs Office Suite 320 Painesville OH 44077-3910 Ph: (440) 350-5669 | Lake County Sheriffs Office Jail Treatment Program 104 East Erie Street Suite 320 Painesville OH 44077-3910 Ph: (440) 350-5669 |
| NPI Number | 1699863316 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699863316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6655 (Ohio) | Primary |
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