Provider Demographics
NPI:1538848932
Name:NICK AMSTER, INC.
Entity type:Organization
Organization Name:NICK AMSTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VANETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-264-9667
Mailing Address - Street 1:1700B OLD MANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7212
Mailing Address - Country:US
Mailing Address - Phone:330-264-9667
Mailing Address - Fax:330-264-9668
Practice Address - Street 1:1700B OLD MANSFIELD RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7212
Practice Address - Country:US
Practice Address - Phone:330-264-9667
Practice Address - Fax:330-264-9668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services