Cruell, Damon Lamont
Cruell, Damon Lamont is an sole proprietor health care provider with primary practice located at 809 W Vine St , Lima OH 45804-1054. He recently has 2 registered licenses in different health care specialties including Agencies / Case Management, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Cruell, Damon Lamont can be contacted via phone (419) 222-4474.Contact Information
Primary practice address
809 W Vine St
Lima OH 45804-1054
Phone: (419) 222-4474
Fax: (419) 222-7044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Case Management | 251B00000X | 1134502404 | Ohio |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1134502404 | Ohio |
Profile Details
| NPI number | 1134502404 |
|---|---|
| LBN Legal business name | Cruell, Damon Lamont |
| Credentials | CDCA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2015 |
| Last updated | Jul 7th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134502404 | NPPES |
| Ohio | MEDICAID | 1134502404 |
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