Mansfield Group Home, Ltd

NPI 1063409738 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1063409738
Enumeration Date 09/28/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name TRACY R TRACY
Position CORP. OFFICE EXECUTIVE ASSISTANT
Phone (419) 524-2335
Fax (419) 522-4391
Practice Location
245 W 4TH ST
MANSFIELD OH, 44903-1704, US
Phone (419) 524-2335
Fax (419) 522-4391
Business Location
245 W 4TH ST
MANSFIELD OH, 44903-1704, US
Phone (419) 524-2335
Fax (419) 522-4391
Toxanomy
Taxonomy Code 315P00000X
License State Ohio
License Number 15636
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According to our database, Mansfield Group Home, Ltd NPI is 1063409738, taxonomy code is 315P00000X and license number is 15636, license state is located at Ohio. Mansfield Group Home, Ltd physically located at 245 W 4th St, Mansfield OH, 44903-1704. NPI Number 1033115704 has the healthcare provider type.

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1063409738 NPI number is provided on an as is basis without warranty of any kind. 1063409738 is maintained by the National Plan & Provider Enumeration System. The contents of Mansfield Group Home, Ltd are for informational purposes only.