| 92nd Street Psych Llc | |
|
433 N Main St Hudson OH 44236-2247 | |
| (330) 968-7872 | |
| Not Available |
| Full Name | 92nd Street Psych Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 433 N Main St, Hudson, Ohio |
| Authorized Official Name and Position | Lisa Sullivan (CREDENTIALING) |
| Authorized Official Contact | 4404530754 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 92nd Street Psych Llc 433 N Main St Hudson OH 44236-2247 Ph: (330) 968-7872 | 92nd Street Psych Llc 433 N Main St Hudson OH 44236-2247 Ph: (330) 968-7872 |
| NPI Number | 1003614181 |
|---|---|
| Provider Enumeration Date | 03/05/2025 |
| Last Update Date | 03/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003614181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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