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Organization
THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC.
Active
Organization
THE CENTER FOR INDIVIDUAL AND FAMILY SERVICES, INC.
Active
Other names
Catalyst Life Services
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ELIZABETH MONTGOMERY (CEO)
(419) 774-6705
Entity
Organization
Contact information
Practice address
741 SCHOLL RD, MANSFIELD, OH 44907-1571
(419) 756-1717
(419) 774-5955
Mailing address
741 SCHOLL RD, MANSFIELD, OH 44907-1571
(419) 756-1717
(419) 774-5955
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
0190
OH
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
4158
OH
320800000X
Mental Illness Community Based Residential Treatment Facility
5-1724,5-0237,6-1980
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201230
—
OH
01
—
136852000
MAGELLAN
—
01
—
4158
MACSIS
OH
01
—
9212121
MEDICARE PTAN
OH
Enumeration date
07/30/2006
Last updated
04/06/2023
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