Provider Demographics
NPI:1285323667
Name:THERAPEUTIC STRENGTH-BASED SERVICES
Entity type:Organization
Organization Name:THERAPEUTIC STRENGTH-BASED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:KOCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:216-260-1405
Mailing Address - Street 1:2359 KNOLLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1525
Mailing Address - Country:US
Mailing Address - Phone:216-260-1405
Mailing Address - Fax:
Practice Address - Street 1:333 N MIDDLE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-1001
Practice Address - Country:US
Practice Address - Phone:330-728-3410
Practice Address - Fax:330-632-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty