Organization
CRISIS INTERVENTION AND RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARD S JESIOLOWSKI PHD, PCCS (EXECUTIVE DIRECTOR)
(330) 452-9812
Entity
Organization
Contact information
Practice address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
(330) 455-9407
(330) 430-1288
Mailing address
832 MCKINLEY AVE NW, CANTON, OH 44703-2463
(330) 455-9407
(330) 430-1288
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
061039
OH
101YM0800X
Mental Health Counselor
Primary
I0800333
OH
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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