Provider Demographics
NPI:1780409318
Name:ADVANTAGE FAMILY OUTREACH & FOSTER CARE
Entity type:Organization
Organization Name:ADVANTAGE FAMILY OUTREACH & FOSTER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JERACA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:419-571-2800
Mailing Address - Street 1:3269 LETTER KENNY LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-6057
Mailing Address - Country:US
Mailing Address - Phone:419-571-2800
Mailing Address - Fax:
Practice Address - Street 1:147 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-1439
Practice Address - Country:US
Practice Address - Phone:419-526-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty