Healthcare Provider Details
I. General information
NPI: 1821127952
Provider Name (Legal Business Name): CHILD GUIDANCE & FAMILY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 08/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
87 N CANTON RD
AKRON OH
44305
US
IV. Provider business mailing address
87 N CANTON RD
AKRON OH
44305-3838
US
V. Phone/Fax
- Phone: 330-794-4254
- Fax: 330-794-4262
- Phone: 330-794-4254
- Fax: 330-794-4262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | 0137 |
| License Number State | OH |
VIII. Authorized Official
Name:
TERRY
NEAVILLE
Title or Position: CONTROLLER
Credential:
Phone: 330-794-4254