Provider Demographics
NPI:1962536854
Name:HUMAN DEVELOPMENT AND COUNSELING ASSOC INC
Entity type:Organization
Organization Name:HUMAN DEVELOPMENT AND COUNSELING ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY,TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:330-494-4636
Mailing Address - Street 1:4792 MUNSON ST NW
Mailing Address - Street 2:MUNSON PROFESSIONAL CENTRE
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3630
Mailing Address - Country:US
Mailing Address - Phone:330-494-4636
Mailing Address - Fax:330-494-5861
Practice Address - Street 1:4792 MUNSON ST NW
Practice Address - Street 2:MUNSON PROFESSIONAL CENTRE
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3630
Practice Address - Country:US
Practice Address - Phone:330-494-4636
Practice Address - Fax:330-494-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0824362Medicaid
OH0824362Medicaid