Provider Demographics
NPI:1891175873
Name:ANITA MORENO & ASSOCIATES LLC
Entity Type:Organization
Organization Name:ANITA MORENO & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:LISWS
Authorized Official - Phone:440-506-3481
Mailing Address - Street 1:31674 CENTER RIDGE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-2400
Mailing Address - Country:US
Mailing Address - Phone:440-506-3481
Mailing Address - Fax:440-249-7267
Practice Address - Street 1:31674 CENTER RIDGE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-2400
Practice Address - Country:US
Practice Address - Phone:440-506-3481
Practice Address - Fax:440-249-7267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI75991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty