Provider Demographics
NPI:1962766394
Name:FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO, INC.
Entity type:Organization
Organization Name:FAMILY PLANNING ASSOCIATION OF NORTHEAST OHIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNNE-PEASPANEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-352-0608
Mailing Address - Street 1:54 S STATE ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3445
Mailing Address - Country:US
Mailing Address - Phone:440-352-0608
Mailing Address - Fax:440-352-0640
Practice Address - Street 1:5192 CHILLICOTHE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-4196
Practice Address - Country:US
Practice Address - Phone:440-352-0608
Practice Address - Fax:440-352-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Single Specialty