# FOSTORIA ALCOHOL/DRUG CENTER

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

## Provider details

- **NPI number:** 1669885265
- **Authorized official:** MARY ZIMMERMAN LICDC-CS/SAP/ICCS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (419) 435-9465

## Contact information

- **Practice address:** 222 S MAIN ST STE B, FOSTORIA, OH 44830-2321
- **Practice address phone:** (419) 435-9465
- **Practice address fax:** (419) 435-0493
- **Mailing address:** 222 S MAIN ST STE B, FOSTORIA, OH 44830-2321
- **Mailing address phone:** (419) 435-9465
- **Mailing address fax:** (419) 435-0493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 1479 | OH | Yes |

## Other

- **Enumeration date:** 06/11/2014
- **Last updated:** 06/11/2014