Healthcare Provider Details

I. General information

NPI: 1861893109
Provider Name (Legal Business Name): FAMILY SERVICE OF NORTHWEST OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 09/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FREEDOM DR
NAPOLEON OH
43545-9038
US

IV. Provider business mailing address

701 JEFFERSON AVE STE 301
TOLEDO OH
43604-6957
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-1660
  • Fax: 419-592-8336
Mailing address:
  • Phone: 419-244-5511
  • Fax: 419-321-6459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number06-7511
License Number StateOH

VIII. Authorized Official

Name: MR. JAMES E. JONES
Title or Position: PRESIDENT & CEO
Credential: MSW
Phone: 419-244-5511