Provider Demographics
NPI:1346856572
Name:ENHANCED SERVICES, LLC
Entity Type:Organization
Organization Name:ENHANCED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICDC
Authorized Official - Phone:419-322-1503
Mailing Address - Street 1:3550 EXECUTIVE PKWY STE 7-234
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1379
Mailing Address - Country:US
Mailing Address - Phone:419-322-1503
Mailing Address - Fax:
Practice Address - Street 1:3550 EXECUTIVE PKWY STE 7-234
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1379
Practice Address - Country:US
Practice Address - Phone:419-322-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty