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Organization

CITILOOKOUT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID EARL ERVIN (AGENCY DIRECTOR)
(937) 322-6532
Entity
Organization

Contact information

Practice address
616 N LIMESTONE ST, SPRINGFIELD, OH 45503-4175
(937) 322-6532
Mailing address
616 N LIMESTONE ST, SPRINGFIELD, OH 45503-4175
(937) 322-6532

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
01/17/2025
Last updated
01/17/2025
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