Provider Demographics
NPI:1083457188
Name:DEEPER FOCUS LLC
Entity type:Organization
Organization Name:DEEPER FOCUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANYELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, MSW
Authorized Official - Phone:330-774-5633
Mailing Address - Street 1:1601 MOTOR INN DR STE 115
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-2420
Mailing Address - Country:US
Mailing Address - Phone:234-237-4489
Mailing Address - Fax:330-744-8625
Practice Address - Street 1:1601 MOTOR INN DR STE 115
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-2420
Practice Address - Country:US
Practice Address - Phone:234-237-4489
Practice Address - Fax:330-744-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty