Most Relevant Information
Provider Data
| NPI Number: | 1003472101 |
| Provider Name: | ALICIA CAROL GREATHOUSE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: | CDCA166934 |
Most Important Dates
| Enumeration Date: | 05/14/2019 |
| Last Updated: | 05/23/2019 |
Provider Practice Location
964 N MARKET ST
LISBON
OH
444329363
Practice Location Phone/Fax
| Phone: | 3304241468 |
| Fax: |
Provider Mailing Location
46384 5TH ST
EAST LIVERPOOL
OH
439203816
Provider Mailing Phone/Fax
| Phone: | 3302719912 |
| Fax: |