Basic Information
Provider Information
NPI: 1225676497
EntityType: 2
ReplacementNPI:  
OrganizationName: FAMILY HEALTH SERVICES OF ERIE COUNTY
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Mailing Information
Address1: 1912 HAYES AVE
Address2:  
City: SANDUSKY
State: OH
PostalCode: 448704736
CountryCode: US
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Practice Location
Address1: 2130 HAYES AVE RM 152
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City: SANDUSKY
State: OH
PostalCode: 448704740
CountryCode: US
TelephoneNumber: 4195022800
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Other Information
ProviderEnumerationDate: 12/18/2019
LastUpdateDate: 09/08/2020
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AuthorizedOfficialLastName: BINKLEY
AuthorizedOfficialFirstName: MARLANA
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AuthorizedOfficialTitleorPosition: EXECUTIVE ASSISTANT
AuthorizedOfficialTelephone: 4195022819
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IsOrganizationSubpart: N
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NPICertificationDate: 09/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM0801X  N Ambulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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