Healthcare Provider Details

I. General information

NPI: 1336486703
Provider Name (Legal Business Name): FAMILY COUNSELING AND REHABILITATION CENTER OF OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2013
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1227 20TH ST
PARKERSBURG WV
26101-3419
US

IV. Provider business mailing address

PO BOX 216
BELPRE OH
45714-0216
US

V. Phone/Fax

Practice location:
  • Phone: 304-893-7580
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER ANN SIMMONS
Title or Position: OWNER
Credential:
Phone: 304-893-7580