Organization
LIFECARE FAMILY HEALTH AND DENTAL CENTER, INC
Active
Organization
LIFECARE FAMILY HEALTH AND DENTAL CENTER, INC
Active
Other names
CANTON COMMUNITY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN M SEEBERGER (CHIEF EXECUTIVE OFFICER)
(330) 454-2000
Entity
Organization
Contact information
Practice address
408 9TH ST SW, CANTON, OH 44707-4714
(330) 454-2000
(330) 454-7284
Mailing address
2725 LINCOLN ST E, CANTON, OH 44707-2769
(330) 454-2000
(330) 454-7284
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099810
—
OH
Enumeration date
05/29/2007
Last updated
05/02/2019
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