Provider Demographics
NPI:1285924522
Name:THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES
Entity type:Organization
Organization Name:THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFF
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:419-756-1717
Mailing Address - Street 1:741 SCHOLL RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1571
Mailing Address - Country:US
Mailing Address - Phone:419-774-2250
Mailing Address - Fax:
Practice Address - Street 1:741 SCHOLL RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1571
Practice Address - Country:US
Practice Address - Phone:419-774-2250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1100050251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health