Organization
COUNSELING CENTER OF WAYNE & HOLMES COUNTIES
Active
Parent organization
SOURCEONE GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOURCEONE GROUP INC
Authorized official
DIANE SUSAN DERUE MPA, LSW (VICE PRESIDENT)
(330) 264-9029
Entity
Organization
Contact information
Practice address
2285 BENDEN DR, WOOSTER, OH 44691-2568
(330) 264-9029
Mailing address
2285 BENDEN DR, WOOSTER, OH 44691-2568
(330) 264-9029
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
02/25/2019
Last updated
02/25/2019
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