Organization
BE HEALED FAMILY OUTREACH
Active
Other names
Success 1 Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIN. JEROME C. RIVERS LPCC-S, LIMFT, CCDC1 (EXECUTIVE DIRECTOR)
(216) 224-4254
Entity
Organization
Contact information
Practice address
670 BROADWAY AVE, BEDFORD, OH 44146-3642
(440) 439-9250
(216) 641-7330
Mailing address
670 BROADWAY AVE, BEDFORD, OH 44146-3642
(440) 439-9250
(216) 641-7330
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
011102
OH
101YP1600X
Pastoral Counselor
E4292
OH
101YP2500X
Professional Counselor
E4292
OH
106H00000X
Marriage & Family Therapist
Primary
F120
OH
Other
Enumeration date
07/24/2007
Last updated
07/24/2007
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