Provider Demographics
NPI:1578822334
Name:THE GIVING TREE, INC.
Entity Type:Organization
Organization Name:THE GIVING TREE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:E
Authorized Official - Last Name:KERSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-898-0077
Mailing Address - Street 1:11969 W STATE ROUTE 105
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-9168
Mailing Address - Country:US
Mailing Address - Phone:419-898-0077
Mailing Address - Fax:419-898-0077
Practice Address - Street 1:335 BUCKEYE BLVD
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-1423
Practice Address - Country:US
Practice Address - Phone:419-734-2942
Practice Address - Fax:419-734-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2863978Medicaid