Provider Demographics
NPI:1205543337
Name:TAKELLA FOUNDATION
Entity type:Organization
Organization Name:TAKELLA FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPCC-S
Authorized Official - Phone:216-816-3400
Mailing Address - Street 1:526 S MAIN ST STE 107
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-4402
Mailing Address - Country:US
Mailing Address - Phone:216-816-3400
Mailing Address - Fax:330-313-3849
Practice Address - Street 1:526 S MAIN ST STE 107
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-4402
Practice Address - Country:US
Practice Address - Phone:216-816-3400
Practice Address - Fax:330-313-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty