Provider Demographics
NPI:1457631582
Name:THE LENZY FAMILY INSTITUTE
Entity Type:Organization
Organization Name:THE LENZY FAMILY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:330-685-0344
Mailing Address - Street 1:3757 CLEVELAND AVE NW
Mailing Address - Street 2:CANTONOHIO
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2374
Mailing Address - Country:US
Mailing Address - Phone:330-956-5623
Mailing Address - Fax:330-956-5936
Practice Address - Street 1:3757 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2374
Practice Address - Country:US
Practice Address - Phone:330-956-5623
Practice Address - Fax:330-956-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13009261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder