Provider Demographics
NPI:1295396075
Name:SAFETY FORCES SUPPORT CENTER
Entity type:Organization
Organization Name:SAFETY FORCES SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:BALASH
Authorized Official - Suffix:III
Authorized Official - Credentials:LPCC-S, LCDC-III
Authorized Official - Phone:330-376-0091
Mailing Address - Street 1:501 W MARKET ST STE 313
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1842
Mailing Address - Country:US
Mailing Address - Phone:330-376-0091
Mailing Address - Fax:
Practice Address - Street 1:501 W MARKET ST STE 313
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1842
Practice Address - Country:US
Practice Address - Phone:330-376-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health