Provider Demographics
NPI:1831460450
Name:FOR OUR CHILDREN'S ULTIMATE SUCCESS
Entity Type:Organization
Organization Name:FOR OUR CHILDREN'S ULTIMATE SUCCESS
Other - Org Name:F.O.C.U.S.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KARMEAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:FOWLKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-254-4143
Mailing Address - Street 1:3530 WARRENSVILLE CENTER RD
Mailing Address - Street 2:101D
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5278
Mailing Address - Country:US
Mailing Address - Phone:216-254-4143
Mailing Address - Fax:
Practice Address - Street 1:3530 WARRENSVILLE CENTER ROAD
Practice Address - Street 2:101D
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-254-4143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1459780251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0059248Medicaid