# DEPARTMENT OF VETERAN'S AFFAIRS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073761490
- **Authorized official:** MS. KATHLEEN COONEY LISW-S (SOCIAL WORK SUPERVISOR)
- **Authorized official phone:** (419) 625-7350

## Contact information

- **Practice address:** 15655 STATE ROUTE 170 SUITE A, CALCUTTA/EAST LIVERPOOL CBOC VA OUTPATIENT CLINIC, CALCUTTA, OH 43920
- **Practice address phone:** (330) 386-4303
- **Practice address fax:** (330) 386-6020
- **Mailing address:** 15655 STATE ROUTE 170 SUITE A, CALCUTTA/EAST LIVERPOOL CBOC VA OUTPATIENT CLINIC, CALCUTTA, OH 43920
- **Mailing address phone:** (330) 386-4303
- **Mailing address fax:** (330) 386-6020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 7493 | TN | Yes |

## Other

- **Enumeration date:** 08/28/2008
- **Last updated:** 08/28/2008