Organization
COLEMAN PROFESSIONAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA D. KEATHLEY (HR COORDINATOR)
(330) 676-6875
Entity
Organization
Contact information
Practice address
5982 RHODES RD, KENT, OH 44240-4128
(330) 673-1347
(330) 678-3677
Mailing address
5982 RHODES RD, KENT, OH 44240-4128
(330) 673-1347
(330) 678-3677
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0227
OH
251S00000X
Community/Behavioral Health Agency
0227
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3147768
AOD MEDICAID
OH
Enumeration date
11/30/2006
Last updated
05/21/2012
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