| NPI | 1952601874 |
|---|---|
| Doing Business As | MONON AVENUE HOME |
| Entity Type | Organization |
| Authorized Contact | KURT MILLER President 330-307-6816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2012-12-28 |