Provider Demographics
NPI:1548488018
Name:VETREANS ADMINISTRATION
Entity type:Organization
Organization Name:VETREANS ADMINISTRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MINOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:CNS
Authorized Official - Phone:330-740-9200
Mailing Address - Street 1:7220 PINE GROVE DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-3030
Mailing Address - Country:US
Mailing Address - Phone:330-534-2732
Mailing Address - Fax:
Practice Address - Street 1:2031 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-2401
Practice Address - Country:US
Practice Address - Phone:330-740-9200
Practice Address - Fax:330-740-9250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS-02221251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health