Provider Demographics
NPI:1437418001
Name:TRAVCO BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:TRAVCO BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-286-0050
Mailing Address - Street 1:8261 MARKET ST STE A
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6254
Mailing Address - Country:US
Mailing Address - Phone:330-286-0050
Mailing Address - Fax:
Practice Address - Street 1:8261 MARKET ST STE A
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-6254
Practice Address - Country:US
Practice Address - Phone:330-286-0050
Practice Address - Fax:330-286-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2864511Medicaid