Healthcare Provider Details

I. General information

NPI: 1932274065
Provider Name (Legal Business Name): FAMILY AND COMMUNITY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 GOUGLER AVE
KENT OH
44240-2401
US

IV. Provider business mailing address

143 GOUGLER AVE
KENT OH
44240-2401
US

V. Phone/Fax

Practice location:
  • Phone: 330-677-4124
  • Fax: 330-677-4134
Mailing address:
  • Phone: 330-677-4124
  • Fax: 330-677-4134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number159
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number159
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number159
License Number StateOH

VIII. Authorized Official

Name: MR. MARK ANTHONY FRISONE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 330-677-4124