IndividualActive
Gerald Polk, CDCA
NPI 1831696970 · Children's Substance Abuse Rehabilitation Facility · Shelby, OH
Provider details
- NPI number
- 1831696970
- Entity type
- Individual
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Credential
- CDCA
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
2775 State Route 39
Shelby, OH 44875-9466
Phone: (419) 747-3322
Approximate (ZIP-level) locationGet directions
Mailing address
2775 State Route 39
Shelby, OH 44875-9466
Registry dates
- Enumerated
- 2018-04-06
- Last updated
- 2018-04-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.