Basic Information
| Provider Information | |||||||||
| NPI: | 1902099989 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FAMILY SERVICE OF NORTHWEST OHIO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 STRANAHAN SQ | ||||||||
| Address2: | SUITE 414 | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436041447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192445511 | ||||||||
| FaxNumber: | 4193216459 | ||||||||
| Practice Location | |||||||||
| Address1: | 228 S MAIN ST | ||||||||
| Address2: | FOUR COUNTY FAMILY CENTER | ||||||||
| City: | BRYAN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435061755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8005936000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2007 | ||||||||
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| AuthorizedOfficialLastName: | SHORT | ||||||||
| AuthorizedOfficialFirstName: | KATHY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8006936000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | I0009991 | OH | N | Agencies | Community/Behavioral Health | 251B00000X | I0009991 | OH | Y | Agencies | Case Management |
No ID Information.