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General NPI Number Information
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NPI Number | 1538497243
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Entity Type | Organization
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Legal Business Name | SYLVANIA AREA FAMILY SERVICES
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 5440 MARSHALL RD
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City | SYLVANIA
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State | OH
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Zip | 43560-2030
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Country | US
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Telephone | 419-882-8415
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 MARSHALL ROAD
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City | SYLVANIA
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State | OH
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Zip | 43560
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Country | US
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Telephone | 419-882-8415
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JASON ROBERTSON
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Credential |
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Telephone | 419-882-8415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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