Organization
LIFECARE FAMILY HEALTH AND DENTAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET MCPEEK (CFO)
(234) 521-7213
Entity
Organization
Contact information
Practice address
820 AMHERST RD NE, MASSILLON, OH 44646-8525
(303) 454-2000
(330) 454-6184
Mailing address
2725 LINCOLN ST E, CANTON, OH 44707-2769
(330) 454-2000
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0171070
—
OH
Enumeration date
11/20/2015
Last updated
05/02/2019
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