Provider Demographics
NPI:1376971978
Name:NEXT TO KIN SUPPORTIVE SERVICES
Entity type:Organization
Organization Name:NEXT TO KIN SUPPORTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUCSHUNDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-510-7847
Mailing Address - Street 1:1149 BETHANY AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2612
Mailing Address - Country:US
Mailing Address - Phone:330-510-7847
Mailing Address - Fax:
Practice Address - Street 1:1149 BETHANY AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2612
Practice Address - Country:US
Practice Address - Phone:330-510-7847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health