| Licking County Alcoholism Prevention Program | |
|
62 E Stevens St Newark OH 43055-5969 | |
| (740) 366-7303 | |
| Not Available |
| Full Name | Licking County Alcoholism Prevention Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 62 E Stevens St, Newark, Ohio |
| Authorized Official Name and Position | John Jordan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7404039494 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Licking County Alcoholism Prevention Program 62 E Stevens St Newark OH 43055-5969 Ph: (740) 366-7303 | Licking County Alcoholism Prevention Program 62 E Stevens St Newark OH 43055-5969 Ph: (740) 366-7303 |
| NPI Number | 1114462892 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114462892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 017553 (Ohio) | Primary |
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