Provider Demographics
NPI:1326290354
Name:THE HOUSE OF SAMUEL, INC.
Entity Type:Organization
Organization Name:THE HOUSE OF SAMUEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:740-439-5634
Mailing Address - Street 1:420 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-1844
Mailing Address - Country:US
Mailing Address - Phone:740-439-5634
Mailing Address - Fax:740-439-0505
Practice Address - Street 1:420 N 8TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-1844
Practice Address - Country:US
Practice Address - Phone:740-439-5634
Practice Address - Fax:740-439-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH52691553251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health