Basic Information
| Provider Information | |||||||||
| NPI: | 1427415587 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY SERVICE OF NORTHWEST OHIO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 JEFFERSON AVE | ||||||||
| Address2: | SUITE 301 | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436046955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4197253434 | ||||||||
| FaxNumber: | 4193216459 | ||||||||
| Practice Location | |||||||||
| Address1: | 7320 STATE HIGHWAY 108 | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WAUSEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435678200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193353732 | ||||||||
| FaxNumber: | 4193353462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2016 | ||||||||
| LastUpdateDate: | 01/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | CAROL | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF HUMAN RESOURCE | ||||||||
| AuthorizedOfficialTelephone: | 4197253434 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | OH | Y | Agencies | Case Management |
No ID Information.