JAY-RANDOLPH DEVELOPMENTAL SERVICES, INC.
Intermediate Care Facility, Mentally Retarded
Portland, Indiana
Provider NPI: 1831143478
Organization Information:Organization Name: JAY-RANDOLPH DEVELOPMENTAL SERVICES, INC.
Practice Location:
901 E WATER ST PORTLAND, IN 47371 US
Tel: 260-726-7931 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Practice Location:
901 E WATER ST PORTLAND, IN 47371 US
Tel: 260-726-7931 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | IN | 2623I0004JN07 |
N | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | IN | 2623B0006JN06 |
N | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | IN | 2623T0003JN07 |
Y | 315P00000X | Nursing & Custodial Care Facilities Intermediate Care Facility, Mentally Retarded | IN | 2623I0005JN06 |