Provider Demographics
NPI:1154749950
Name:ADO HEALTH SERVICES INC.
Entity type:Organization
Organization Name:ADO HEALTH SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENDRA TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:CCS
Authorized Official - Phone:330-629-2888
Mailing Address - Street 1:1011 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4226
Mailing Address - Country:US
Mailing Address - Phone:330-629-2888
Mailing Address - Fax:330-629-8940
Practice Address - Street 1:1025 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4227
Practice Address - Country:US
Practice Address - Phone:330-629-2434
Practice Address - Fax:330-629-2199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADO HEALTH SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-31
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0153615Medicaid
36D2092456OtherCLIA WAIVER
OH13855OtherMEDICAID OMHAS
OH0153615Medicaid