Cruell, Damon Lamont

Cruell, Damon Lamont is an sole proprietor health care provider with primary practice located at 809 W Vine St , Lima OH 45804-1054. He recently has 2 registered licenses in different health care specialties including Agencies / Case Management, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Cruell, Damon Lamont can be contacted via phone (419) 222-4474.

Contact Information

Primary practice address
809 W Vine St Lima OH 45804-1054
Phone: (419) 222-4474
Fax: (419) 222-7044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X 1134502404 Ohio
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1134502404 Ohio

Profile Details

NPI number 1134502404
LBN Legal business name Cruell, Damon Lamont
Credentials CDCA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 6th, 2015
Last updated Jul 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134502404 NPPES
Ohio MEDICAID 1134502404

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