Provider Demographics
NPI:1528474459
Name:GREATER CANTON PSYCHIATRY, LLC
Entity type:Organization
Organization Name:GREATER CANTON PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VRACIU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-492-6500
Mailing Address - Street 1:4773 HIGBEE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2551
Mailing Address - Country:US
Mailing Address - Phone:330-492-6500
Mailing Address - Fax:330-492-6502
Practice Address - Street 1:4773 HIGBEE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2551
Practice Address - Country:US
Practice Address - Phone:330-492-6500
Practice Address - Fax:330-492-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty