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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