MEDICARE: OPTIONS FOR FAMILIES AND YOUTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	0629	OH

General Provider Information

NPI Number	:	1003065566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIONS FOR FAMILIES AND YOUTH

Provider Business Mailing Address
First Line	:	5131 W 140TH ST
Second Line	:
City	:	BROOK PARK
State	:	OH
Zip	:	44142-1755
Country	:	US
Telephone Number	:	216-267-7070
Fax Number	:	216-267-7075

Provider Business Practice Location Address
First Line	:	5131 W 140TH ST
Second Line	:
City	:	BROOK PARK
State	:	OH
Zip	:	44142-1755
Country	:	US
Telephone Number	:	216-267-7070
Fax Number	:	216-267-7075

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	DR. FRANCIS J. MATESE
Credential	:	PH.D.
Telephone Number	:	216-267-7070

Provider Enumeration Date	:	09/09/2008
Last Update Date	:	09/12/2008

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Directions to “OPTIONS FOR FAMILIES AND YOUTH ” Practice Location

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