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Organization

THIRD STREET COMMUNITY CLINIC INC

Active
Parent organization
THIRD STREET COMMUNITY CLINIC INC
Other names
FIVE POINTS PRIMARY CARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
THIRD STREET COMMUNITY CLINIC INC
Authorized official
PEGGY ANDERSON (CEO)
(419) 526-7880
Entity
Organization

Contact information

Practice address
200 PARK AVE W, MANSFIELD, OH 44902-1608
(419) 522-2239
Mailing address
600 W 3RD ST, MANSFIELD, OH 44906-2633
(419) 522-6191

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QP2300X
Primary Care Clinic/Center
Primary
3336C0002X
Clinic Pharmacy

Other

Enumeration date
03/11/2022
Last updated
03/11/2022
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