Provider Demographics
NPI:1356525224
Name:KREUZ CLINICAL SERVICES, INC
Entity type:Organization
Organization Name:KREUZ CLINICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:KREUZ
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, LICDC, LIMFT
Authorized Official - Phone:614-325-6752
Mailing Address - Street 1:2525 OAKSTONE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-7612
Mailing Address - Country:US
Mailing Address - Phone:614-325-6752
Mailing Address - Fax:614-436-5138
Practice Address - Street 1:2525 OAKSTONE DR
Practice Address - Street 2:SUITE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-7612
Practice Address - Country:US
Practice Address - Phone:614-325-6752
Practice Address - Fax:614-436-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF117174400000X
OH841152174400000X
OHI47161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKR9336811Medicare PIN