Organization
THIRD STREET COMMUNITY CLINIC INC
Active
Other names
Community Counseling & Wellness Centers-Bucyrus
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY ANDERSON (CEO)
(419) 526-7880
Entity
Organization
Contact information
Practice address
2458 STETZER RD, BUCYRUS, OH 44820
(419) 522-6191
Mailing address
1404 PARK AVE W SUITE 2, MANSFIELD, OH 44906
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261Q00000X
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
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/05/2023
Last updated
10/29/2024
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