Third Street Community Clinic, INC

NPI #1194592154 in Marion, Ohio

Provider Information

NPI Number: 1194592154
Entity Type: Organization
Organization Name: Third Street Community Clinic, INC
Primary Specialty: Clinic/Center
Enumeration Date: Dec 8, 2023
Last Updated: Oct 29, 2024

Practice Location

Address: 320 EXECUTIVE DR
City: Marion
State: Ohio
ZIP Code: 43302-6310
Phone: (740) 383-1351

Authorized Official

Name: PEGGY ANDERSON
Title: CEO
Phone: (419) 526-7880

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center	261Q00000X	Primary

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