Organization
THIRD STREET COMMUNITY CLINIC INC
Active
Parent organization
THIRD STREET COMMUNITY CLINIC INC
Other names
Shelby Health and Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
THIRD STREET COMMUNITY CLINIC INC
Authorized official
PEGGY ANDERSON (CEO)
(419) 526-7880
Entity
Organization
Contact information
Practice address
31 E MAIN ST, SHELBY, OH 44875-1262
(419) 522-6191
Mailing address
1404 PARK AVE W, STE 2, MANSFIELD, OH 44906-2633
(419) 522-6191
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental 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
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
02/25/2022
Last updated
10/29/2024
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