Provider Demographics
NPI:1962435453
Name:BIG BROTHERS BIG SISTERS OF LORAIN COUNTY,INC.
Entity type:Organization
Organization Name:BIG BROTHERS BIG SISTERS OF LORAIN COUNTY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-277-6541
Mailing Address - Street 1:1917 N RIDGE RD E
Mailing Address - Street 2:SUITE A
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3378
Mailing Address - Country:US
Mailing Address - Phone:440-277-6541
Mailing Address - Fax:440-277-6583
Practice Address - Street 1:1917 N RIDGE RD E
Practice Address - Street 2:SUITE A
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3378
Practice Address - Country:US
Practice Address - Phone:440-277-6541
Practice Address - Fax:440-277-6583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management