IndividualActive
Dustin Kubacka, CDCA
NPI 1306347885 · Substance Abuse Rehabilitation Facility · Warren, OH
Provider details
- NPI number
- 1306347885
- Entity type
- Individual
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Credential
- CDCA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 165529 (OH)
Mailing address
2737 Youngstown Rd Se
Warren, OH 44484-5002
Registry dates
- Enumerated
- 2018-02-21
- Last updated
- 2019-06-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.