| NPI | 1558977363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY POWELL President 330-495-6374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 253Z00000X In Home Supportive Care | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |