Provider Demographics
NPI:1013159144
Name:FAMILY THERAPY CENTER
Entity Type:Organization
Organization Name:FAMILY THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:513-861-9797
Mailing Address - Street 1:8040 HOSBROOK RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-2901
Mailing Address - Country:US
Mailing Address - Phone:513-861-9797
Mailing Address - Fax:
Practice Address - Street 1:8040 HOSBROOK RD
Practice Address - Street 2:SUITE 320
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2901
Practice Address - Country:US
Practice Address - Phone:513-861-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 0007109251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health