Provider Demographics
NPI:1104854819
Name:FARRELLCO, INC.
Entity Type:Organization
Organization Name:FARRELLCO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-825-6600
Mailing Address - Street 1:375 GLENSPRINGS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-2316
Mailing Address - Country:US
Mailing Address - Phone:513-825-6600
Mailing Address - Fax:513-825-6696
Practice Address - Street 1:375 GLENSPRINGS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-2316
Practice Address - Country:US
Practice Address - Phone:513-825-6600
Practice Address - Fax:513-825-6696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0156085Medicaid
OH0156085Medicaid
OH0156085Medicaid