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JOSEPHINE HOUSE

Intermediate Care Facility, Mentally Retarded

Brunswick, Ohio

Provider NPI: 1437166824

Organization Information:
Organization Name:  JOSEPHINE HOUSE


Practice Location:
2039 JOSEPHINE BLVD  BRUNSWICK, OH 44212 US
Tel: 330-273-5494  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
OH5210168

Other Provider Identifiers:

IssuerNumberStateType
36-G455OH05
0899185OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS OH - Page 1



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