Provider Demographics
NPI:1013959238
Name:NORTH COAST FAMILY FOUNDATION
Entity Type:Organization
Organization Name:NORTH COAST FAMILY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:MISJA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-842-6867
Mailing Address - Street 1:6902 PEARL RD STE 502
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3621
Mailing Address - Country:US
Mailing Address - Phone:440-842-6867
Mailing Address - Fax:440-842-8914
Practice Address - Street 1:6902 PEARL RD STE 502
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3621
Practice Address - Country:US
Practice Address - Phone:440-842-6867
Practice Address - Fax:440-842-8914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty