Provider Demographics
NPI:1104583277
Name:CHILD AND FAMILY HEALTH COLLABORATIVE
Entity type:Organization
Organization Name:CHILD AND FAMILY HEALTH COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE NETWORK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STADTMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-461-0014
Mailing Address - Street 1:CHILD AND FAMILY HEALTH COLLABORATIVE OF OHIO
Mailing Address - Street 2:2600 CORPORATE EXCHANGE DRIVE, SUITE 180
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231
Mailing Address - Country:US
Mailing Address - Phone:614-461-0014
Mailing Address - Fax:
Practice Address - Street 1:CHILD AND FAMILY HEALTH COLLABORATIVE OF OHIO
Practice Address - Street 2:2600 CORPORATE EXCHANGE DRIVE, SUITE 180
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231
Practice Address - Country:US
Practice Address - Phone:614-461-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-23
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty