Organization
SOURCEONE GROUP INC
Active
Other names
SourceOne
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN D. BUCHWALTER PH.D. (PRESIDENT/CEO)
(330) 345-0955
Entity
Organization
Contact information
Practice address
210 E MILLTOWN RD, SUITE B, WOOSTER, OH 44691-1246
(330) 345-0955
(330) 345-3420
Mailing address
210 E MILLTOWN RD, SUITE B, WOOSTER, OH 44691-1246
(330) 345-0955
(330) 345-3420
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
OH
Other
Enumeration date
10/05/2006
Last updated
01/14/2008
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