Provider Demographics
NPI:1174094189
Name:LET'S GET REAL, INC.
Entity type:Organization
Organization Name:LET'S GET REAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERLE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, LCDC III
Authorized Official - Phone:440-963-7042
Mailing Address - Street 1:1939 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3959
Mailing Address - Country:US
Mailing Address - Phone:440-963-7042
Mailing Address - Fax:440-963-9248
Practice Address - Street 1:1939 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3959
Practice Address - Country:US
Practice Address - Phone:440-963-7042
Practice Address - Fax:440-963-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty