Provider Demographics
NPI:1841526415
Name:CENTER FOR FAMILIES & CHILDREN
Entity type:Organization
Organization Name:CENTER FOR FAMILIES & CHILDREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RCM
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-373-2846
Mailing Address - Street 1:4400 EUCLID AVE
Mailing Address - Street 2:ROOM P101
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3734
Mailing Address - Country:US
Mailing Address - Phone:216-325-9300
Mailing Address - Fax:216-325-9301
Practice Address - Street 1:4400 EUCLID AVE RM P101
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-3734
Practice Address - Country:US
Practice Address - Phone:216-325-9300
Practice Address - Fax:216-325-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336L0003X
OH0219913003336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122478OtherPK
OH0959557Medicaid