Center Street Community Clinic INC

NPI #1346417417 in Marion, Ohio

Provider Information

NPI Number: 1346417417
Entity Type: Organization
Organization Name: Center Street Community Clinic INC
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: May 8, 2008
Last Updated: Jan 21, 2015

Practice Location

Address: 205 W CENTER ST
Address 2: SUITE 200
City: Marion
State: Ohio
ZIP Code: 43302-3700
Phone: (740) 751-4189

Authorized Official

Name: CLIFF G EDWARDS
Title: CEO/EXECUTIVE DIRECTOR
Phone: (740) 751-6380

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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