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NPI Code Detail

MEDICARE: THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC.

MEDICARE: THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC.
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
1261QH0700XHearing and Speech Clinic/Center
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center4158OH
3320800000XMental Illness Community Based Residential Treatment Facility5-1724,5-0237,6-1980OH
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)0190OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
49212121OTHEROHMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1136852000OTHERMAGELLAN
24158OTHEROHMACSIS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487669222
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC.
Provider Business Mailing Address
First Line : 741 SCHOLL RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1571
Country : US
Telephone Number : 419-756-1717
Fax Number : 419-774-5955
Provider Business Practice Location Address
First Line : 741 SCHOLL RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1571
Country : US
Telephone Number : 419-756-1717
Fax Number : 419-774-5955
Authorized Official
Title or Position : CEO
Name : LAURA ELIZABETH MONTGOMERY
Credential :
Telephone Number : 419-774-6705
Provider Enumeration Date : 07/30/2006
Last Update Date : 04/06/2023

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MANSFIELD, OH
44907-1571
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1124952163 — JOSHUA L MILLER
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MANSFIELD, OH
44907-1571
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1740340512 — DR. KAREN SUE LOWE M.D.
Practice Location Address:
741 SCHOLL RD
MANSFIELD, OH
44907-1571
Practice Phone: 419-756-1717
Practice Fax: 419-756-1717

Directions to “THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC. ” Practice Location

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