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1760158034
MICAH INGRAM
WARREN, OH
NPI
1760158034
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
(Licence: OH 177947)
Enumeration Date
2021-08-18
Last Update Date
2021-08-18
Business Address
MICAH INGRAM CDCA
4930 ENTERPRISE DR NW
WARREN, OH 44481-8706
Phone number: 330-787-0955
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Mailing Address
MICAH INGRAM CDCA
4930 ENTERPRISE DR NW
WARREN, OH 44481-8706
Phone number: 330-787-0955
Copy
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