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Organization

CENTER STREET COMMUNITY CLINIC INC

Active
Other names
Center Street Community Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
AUDREY COBB (CFO)
(740) 751-4531
Entity
Organization

Contact information

Practice address
136 W CENTER ST, MARION, OH 43302-3704
(740) 751-6380
(740) 751-4866
Mailing address
136 W CENTER ST, MARION, OH 43302-3704
(740) 751-6380
(740) 751-4866

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1780984211
NPI
OH
05
3148061
OH
Enumeration date
11/01/2010
Last updated
10/29/2025
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