Individual
DUSTIN KUBACKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
2737 YOUNGSTOWN RD SE, WARREN, OH 44484-5002
(330) 369-8022
Mailing address
2737 YOUNGSTOWN RD SE, WARREN, OH 44484-5002
(330) 369-8022
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
165529
OH
324500000X
Substance Abuse Rehabilitation Facility
Primary
168900
OH
Other
Enumeration date
02/21/2018
Last updated
06/17/2019
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