Organization
FAMILY LIFE COUNSELING & PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN COCHRAN (CFO)
(419) 774-9969
Entity
Organization
Contact information
Practice address
151 MARION AVE, MANSFIELD, OH 44903-2223
(419) 774-9969
(419) 756-5642
Mailing address
151 MARION AVE, MANSFIELD, OH 44903-2223
(419) 774-9969
(419) 756-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2864575
—
OH
Enumeration date
05/16/2012
Last updated
05/16/2012
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