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Organization
THE EDNA BROOKS FOUNDATION, INC.
Active
Organization
THE EDNA BROOKS FOUNDATION, INC.
Active
Other names
My Sister's Place
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY COOKE LISW (EXECUTIVE DIRECTOR)
(740) 593-7125
Entity
Organization
Contact information
Practice address
142 E STATE ST, ATHENS, OH 45701-1746
(740) 593-7125
(740) 594-7122
Mailing address
PO BOX 1158, ATHENS, OH 45701-1158
(740) 593-7125
(740) 594-7122
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0003
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10167
—
OH
Enumeration date
06/24/2006
Last updated
12/21/2016
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