Organization
CRISIS INTERVENTION AND RECOVERY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD JESIOLOWSKI PHD. (EXECUTIVE DIRECTOR)
(330) 452-9812
Entity
Organization
Contact information
Practice address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
(330) 452-9812
(330) 430-1288
Mailing address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
0203
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201098
—
OH
05
—
2480864
—
OH
05
—
2863843
—
OH
Enumeration date
04/30/2012
Last updated
04/30/2012
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