Provider Demographics
NPI:1154446722
Name:LUTHERAN FAMILY SERVICES
Entity Type:Organization
Organization Name:LUTHERAN FAMILY SERVICES
Other - Org Name:LUTHERAN CHILDREN'S AID & FAMILY SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLONNA
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LSW, MS
Authorized Official - Phone:216-281-2500
Mailing Address - Street 1:4100 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2842
Mailing Address - Country:US
Mailing Address - Phone:216-281-2500
Mailing Address - Fax:216-281-2506
Practice Address - Street 1:4100 FRANKLIN BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-2842
Practice Address - Country:US
Practice Address - Phone:216-281-2500
Practice Address - Fax:216-281-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0000401251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH273743222001OtherMEDICAL MUTUAL