Etheridge, Charles Earl

Etheridge, Charles Earl is an individual health care provider with primary practice located at 1131 E Broad St , Elyria OH 44035-6305. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Etheridge, Charles Earl can be contacted via phone (440) 365-1900.

Contact Information

Primary practice address
1131 E Broad St Elyria OH 44035-6305
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CDCA.164758 Ohio

Profile Details

NPI number 1245759794
LBN Legal business name Etheridge, Charles Earl
Credentials CDCA
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2017
Last updated Sep 15th, 2017 - about 7 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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