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Organization

GREENLEAF FAMILY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DAWN GLENNY (PRESIDENT/CEO)
(330) 376-9494
Entity
Organization

Contact information

Practice address
580 GRANT ST, AKRON, OH 44311-9910
(330) 376-9494
(330) 376-4525
Mailing address
580 GRANT ST, AKRON, OH 44311-9910
(330) 376-9494
(330) 376-4525

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
01-0198
OH
251S00000X
Community/Behavioral Health Agency
Primary
13654
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2098386
OH
01
H302900
MEDICARE PTAN
OH
Enumeration date
12/03/2014
Last updated
12/09/2014
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