Provider Demographics
NPI:1407511066
Name:FATHERS HEART NURTURING CENTER
Entity Type:Organization
Organization Name:FATHERS HEART NURTURING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALONZO
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MENTOR, FACILITATOR
Authorized Official - Phone:513-658-2024
Mailing Address - Street 1:2374 LOSANTIVILLE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-4445
Mailing Address - Country:US
Mailing Address - Phone:513-658-2024
Mailing Address - Fax:
Practice Address - Street 1:4836 WARD ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2347
Practice Address - Country:US
Practice Address - Phone:513-658-2024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-08
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty