Organization
THIRD STREET COMMUNITY CLINIC INC
Active
Other names
Five Points Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY ANDERSON (CEO)
(419) 522-6191
Entity
Organization
Contact information
Practice address
200 PARK AVE W, MANSFIELD, OH 44902-1608
(419) 522-2239
(419) 525-6723
Mailing address
1404 PARK AVE W, STE 2, 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
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
10/29/2024
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