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Madison Village Manor, Inc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Madison, Ohio
NPI 1154504983

Madison Village Manor, Inc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Madison, OH. Madison Village Manor, Inc practices in Madison, OH. The NPI Number for Madison Village Manor, Inc is 1154504983 and holds a License No. 4310178 (Ohio).

The current practice location address for Madison Village Manor, Inc is 731 N Lake St, Madison, OH and can be reached out via phone at 440-428-1519 and via fax at 440-428-6360.

Location: 731 N Lake St, Madison, OH, 44057-0272
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1154504983
Provider Name
Madison Village Manor, Inc
Credential
Provider Entity Type
Organization
Address
731 N Lake St, Madison, OH, 44057-0272
Phone Number
440-428-1519
Fax Number
440-428-6360
Provider Enumeration Date
12/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1724665 05 OH
institution
Provider Business Practice Location Address Details
Address
731 N Lake St
City
Madison
State
Ohio
Zip
44057-3152
Phone Number
440-428-1519
Fax Number
440-428-6360
person
Provider Business Mailing Address Details
Address
731 N Lake St
City
Madison
State
Ohio
Zip
44057-3152
Phone Number
440-428-1519
Fax Number
440-428-6360
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
4310178 (Ohio)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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