Healthcare Provider Details

I. General information

NPI: 1780409318
Provider Name (Legal Business Name): ADVANTAGE FAMILY OUTREACH & FOSTER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 W MAIN ST
SHELBY OH
44875-1439
US

IV. Provider business mailing address

3269 LETTER KENNY LN
POWELL OH
43065-6057
US

V. Phone/Fax

Practice location:
  • Phone: 419-526-5437
  • Fax:
Mailing address:
  • Phone: 419-571-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JERACA BARNETT
Title or Position: DIRECTOR
Credential: MSW
Phone: 419-961-2198