Center Street Community Clinic, INC

NPI #1306627476 in Marion, Ohio

Provider Information

NPI Number: 1306627476
Entity Type: Organization
Organization Name: Center Street Community Clinic, INC
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Oct 13, 2023
Last Updated: Dec 22, 2023

Practice Location

Address: 125 EXECUTIVE DR STE 201
City: Marion
State: Ohio
ZIP Code: 43302-6302
Phone: (740) 387-3087

Authorized Official

Name: AUDREY COBB
Title: CFO
Phone: (740) 751-4531

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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