Healthcare Provider Details

I. General information

NPI: 1518224799
Provider Name (Legal Business Name): DIRECTIONS FOR YOUTH & FAMILIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 E BROAD ST
COLUMBUS OH
43205-1505
US

IV. Provider business mailing address

1515 INDIANOLA AVE
COLUMBUS OH
43201-2118
US

V. Phone/Fax

Practice location:
  • Phone: 614-251-0103
  • Fax: 614-251-1177
Mailing address:
  • Phone: 614-294-2661
  • Fax: 614-294-3247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number0251
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number0251
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number25149
License Number StateOH

VIII. Authorized Official

Name: MR. DUANE CASARES
Title or Position: CEO
Credential: LISW-S
Phone: 614-294-2661