Organization
THIRD STREET COMMUNITY CLINIC, INC
Active
Other names
Third Street OB/GYN, Cornerstone OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY ANDERSON (CEO)
(419) 526-7880
Entity
Organization
Contact information
Practice address
770 BALGREEN DR STE 207, MANSFIELD, OH 44906-4106
(419) 522-6800
(419) 525-6723
Mailing address
1404 PARK AVE W, STE 2, MANSFIELD, OH 44906-2633
(419) 522-6191
(419) 526-4911
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QB0400X
Birthing Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
273R00000X
Psychiatric Hospital Unit
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
—
—
Other
Enumeration date
05/14/2007
Last updated
10/29/2024
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