Provider Demographics
NPI:1851127195
Name:FIRST RESORT PEER SUPPORT
Entity type:Organization
Organization Name:FIRST RESORT PEER SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:LICDC
Authorized Official - Phone:216-346-8608
Mailing Address - Street 1:5252 RIDGE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-1453
Mailing Address - Country:US
Mailing Address - Phone:216-346-8608
Mailing Address - Fax:216-627-3797
Practice Address - Street 1:5252 RIDGE RD APT 1
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-1453
Practice Address - Country:US
Practice Address - Phone:216-346-8608
Practice Address - Fax:216-627-3797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty