Provider Demographics
NPI:1457926867
Name:HUMILITY OF MARY HOUSING, INC.
Entity type:Organization
Organization Name:HUMILITY OF MARY HOUSING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:234-525-6400
Mailing Address - Street 1:2251 FRONT ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2578
Mailing Address - Country:US
Mailing Address - Phone:234-525-6400
Mailing Address - Fax:330-384-2144
Practice Address - Street 1:2251 FRONT ST STE 210
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-2578
Practice Address - Country:US
Practice Address - Phone:234-525-6400
Practice Address - Fax:330-384-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty