| Organization Name: | ST. ELIZABETH HEALTH CENTER |
| NPI Number: | 1023365749 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUDOLPH KRAFT (PROGRAM DIRECTOR) |
| Mailing Address: | 1053 Belmont Ave Youngstown |
| State: | OH US |
| Postal Code: | 445041007 |
| Phone Number: | 3304803605 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2012 |
| NPI Last Update Date: | 08/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 57.021131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |