Provider Demographics
NPI:1164068540
Name:FIRST AND TWENTY FIVE LLC
Entity Type:Organization
Organization Name:FIRST AND TWENTY FIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:216-417-0047
Mailing Address - Street 1:12305 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44108-2359
Mailing Address - Country:US
Mailing Address - Phone:216-417-0047
Mailing Address - Fax:216-916-4925
Practice Address - Street 1:12305 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44108-2359
Practice Address - Country:US
Practice Address - Phone:216-417-0047
Practice Address - Fax:216-916-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health