Third Street Community Clinic Inc

LBN: Third Street Community Clinic Inc
Third Street Community Clinic Inc is an health care organization with primary practice located at 200 Park Ave W , Mansfield OH 44902-1608. The organization recently has 6 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Ambulatory Health Care Facilities / Podiatric, Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Third Street Community Clinic Inc can be contacted via phone (419) 522-2239, or through Jeremy, Theresa via phone (419) 522-6191.

Contact Information

Primary practice address
200 Park Ave W Mansfield OH 44902-1608
Phone: (419) 522-2239
Fax: (419) 525-6723
Website:
Map and Directions
Authorized official contact:
Name: Jeremy, Theresa
Phone: (419) 522-6191

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Dental 261QD0000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X
Ambulatory Health Care Facilities / Podiatric 261QP1100X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1245858950
LBN Legal business name Third Street Community Clinic Inc
DBA Doing business as
Authorized official Jeremy, Theresa
Entity Organization
Organization subpart 1 No
Enumeration date Jul 9th, 2020
Last updated Jul 9th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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