Provider Demographics
NPI:1770753741
Name:FAMILY SERVICE
Entity type:Organization
Organization Name:FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATANYA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-381-6300
Mailing Address - Street 1:200 MCFARLAND ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2615
Mailing Address - Country:US
Mailing Address - Phone:513-381-6300
Mailing Address - Fax:513-345-8559
Practice Address - Street 1:200 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2615
Practice Address - Country:US
Practice Address - Phone:513-381-6300
Practice Address - Fax:513-345-8559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0800110-TRNE251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2341693Medicaid