MEDICARE: FAMILY THERAPEUTIC SOLUTIONS LLC

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

General Provider Information

NPI Number	:	1821548249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY THERAPEUTIC SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	540 E 105TH ST
Second Line	:	SUITE 100A
City	:	CLEVELAND
State	:	OH
Zip	:	44108-4301
Country	:	US
Telephone Number	:	216-858-6823
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 E 105TH ST
Second Line	:	SUITE 100A
City	:	CLEVELAND
State	:	OH
Zip	:	44108-4301
Country	:	US
Telephone Number	:	216-858-6823
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. PRINCE N NYEPLU
Credential	:
Telephone Number	:	336-655-2711

Provider Enumeration Date	:	10/10/2016
Last Update Date	:	10/10/2016

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Directions to “FAMILY THERAPEUTIC SOLUTIONS LLC ” Practice Location

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