| NPI | 1528439932 |
|---|---|
| Other Name | SOUTH STREET ICF |
| Entity Type | Organization |
| Authorized Contact | STEVEN KING Executive Director 419-866-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2022-04-15 |