Provider Demographics
NPI:1598941080
Name:A. FOX SERVICES, LLC
Entity Type:Organization
Organization Name:A. FOX SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:419-207-1122
Mailing Address - Street 1:1344 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-1479
Mailing Address - Country:US
Mailing Address - Phone:419-207-1122
Mailing Address - Fax:419-496-2287
Practice Address - Street 1:19 W MAIN ST STE 16
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-2282
Practice Address - Country:US
Practice Address - Phone:419-496-2278
Practice Address - Fax:419-496-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-9171251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHFOSW25464Medicare UPIN