Organization
FOSTORIA ALCOHOL/DRUG CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ZIMMERMAN LICDC-CS/SAP/ICCS (EXECUTIVE DIRECTOR)
(419) 435-9465
Entity
Organization
Contact information
Practice address
222 S MAIN ST STE B, FOSTORIA, OH 44830-2321
(419) 435-9465
(419) 435-0493
Mailing address
222 S MAIN ST STE B, FOSTORIA, OH 44830-2321
(419) 435-9465
(419) 435-0493
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1479
OH
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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