Provider Demographics
NPI:1881195543
Name:ANAYA FARRELL ENTERPRISES LLC
Entity Type:Organization
Organization Name:ANAYA FARRELL ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TAX ID OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANAYA
Authorized Official - Middle Name:T
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LIMFT
Authorized Official - Phone:216-406-4970
Mailing Address - Street 1:25901 EMERY RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-6213
Mailing Address - Country:US
Mailing Address - Phone:216-406-4970
Mailing Address - Fax:
Practice Address - Street 1:25901 EMERY RD STE 112
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-6213
Practice Address - Country:US
Practice Address - Phone:216-406-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty