Provider Demographics
NPI:1770776718
Name:FAMILY SERVICE OF NORTHWEST OHIO
Entity type:Organization
Organization Name:FAMILY SERVICE OF NORTHWEST OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT STAFF SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAMOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-335-3732
Mailing Address - Street 1:7320 STATE HIGHWAY 108
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAUSEON
Mailing Address - State:OH
Mailing Address - Zip Code:43567-8200
Mailing Address - Country:US
Mailing Address - Phone:419-335-3732
Mailing Address - Fax:419-335-3462
Practice Address - Street 1:7320 STATE HIGHWAY 108
Practice Address - Street 2:SUITE A
Practice Address - City:WAUSEON
Practice Address - State:OH
Practice Address - Zip Code:43567-8200
Practice Address - Country:US
Practice Address - Phone:419-335-3732
Practice Address - Fax:419-335-3462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0008698251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health