Provider Demographics
NPI:1437347051
Name:BEREA CHILDREN'S HOME AND FAMILY SERVICES
Entity Type:Organization
Organization Name:BEREA CHILDREN'S HOME AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CORSO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:216-337-6238
Mailing Address - Street 1:15200 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4019
Mailing Address - Country:US
Mailing Address - Phone:216-337-6238
Mailing Address - Fax:
Practice Address - Street 1:15200 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-4019
Practice Address - Country:US
Practice Address - Phone:216-337-6238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0700476251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health