Organization · Type 2 NPI

Christine Adaline Ferguson Lsw, Licdc LLC

Children's Substance Abuse Rehabilitation Facility · Maple Heights, OH

NPI number 1679298491 Active

Practice location

16360 Broadway Ave Ste B101
Maple Heights, OH 44137-2573

Call (216) 510-7170 Map

Fax (216) 510-7213

Mailing address

18320 Mapleboro Ave
Maple Heights, OH 44137-2768

Specialties and licenses

Taxonomy	Code	License
Children's Substance Abuse Rehabilitation Facility Primary	3245S0500X	None listed

Children's Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

Another provider at this address

Christine A. Ferguson, LICDC-LISWClinical Social Worker Maple Heights, OH NPI 1831635002

NPI record

NPI: 1679298491
Entity type: Organization (Type 2)
Issued: Oct 4, 2022
Last updated: Oct 4, 2022
Status: Active
Subpart: Yes of Christine Adaline Ferguson, Lsw-Licdc LLC

Other names

Key Counseling Services · doing business as

Authorized official

Christine A Ferguson, LISW
Director
(216) 727-6410

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1679298491

Christine Adaline Ferguson Lsw, Licdc LLC's National Provider Identifier is 1679298491, issued on Oct 4, 2022. The primary taxonomy on file is Children's Substance Abuse Rehabilitation Facility (3245S0500X), and the practice location is in Maple Heights, OH. The record was last updated on Oct 4, 2022.