Provider Demographics
NPI:1427470665
Name:SOCIAL ASSIST LLC
Entity type:Organization
Organization Name:SOCIAL ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S, LICDC, SAP
Authorized Official - Phone:440-523-0165
Mailing Address - Street 1:147 E AURORA RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2084
Mailing Address - Country:US
Mailing Address - Phone:440-523-0165
Mailing Address - Fax:330-748-4780
Practice Address - Street 1:147 E AURORA RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2084
Practice Address - Country:US
Practice Address - Phone:440-523-0165
Practice Address - Fax:330-748-4780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0800419 .SUPV251S00000X
OH131071251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health