Organization
FOUNDATION OF LOVE FOR YOUTH, LLC (FLY HOUSE)
Active
Organization
FOUNDATION OF LOVE FOR YOUTH, LLC (FLY HOUSE)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRA NICOLE MARTIN LMSW, CDCA, CPLC (SOCIAL WORKER)
(614) 598-9891
Entity
Organization
Contact information
Practice address
850 OAK ST, COLUMBUS, OH 43205-1113
(614) 429-3843
(614) 675-7537
Mailing address
PO BOX 992, REYNOLDSBURG, OH 43068-0992
(614) 429-3843
(614) 675-7537
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881064004
—
OH
Enumeration date
11/27/2021
Last updated
11/27/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up