Organization
THIRD STREET COMMUNITY CLINIC, INC
Active
Organization
THIRD STREET COMMUNITY CLINIC, INC
Active
Other names
Mansfield Family Health
Organization subpart
No
Provider details
NPI number
Authorized official
JARED POLLICK (CEO)
(419) 526-7880
Entity
Organization
Contact information
Practice address
741 SCHOLL RD STE A, MANSFIELD, OH 44907-1571
(419) 525-6737
Mailing address
600 W 3RD ST, MANSFIELD, OH 44906-2633
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
—
Enumeration date
02/09/2012
Last updated
10/26/2017
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