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Intellectual and/or Developmental Disabilities Residential Treatment Facility in Canton, Ohio
NPI 1962958512

Individual is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Canton, OH. Individual practices in Canton, OH. The NPI Number for Individual is 1962958512 and holds a License No. (Ohio).

The current practice location address for Individual is 1111 Gonder Av Se, Canton, OH and can be reached out via phone at 330-265-7902. You can also correspond with Individual through the mailing address at 1111 GONDER AV SE, CANTON, OH - 44707 (mailing address contact number: 330-265-7902).

Location: 1111 Gonder Av Se, Canton, OH, 44707
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962958512
Provider Name
Individual
Credential
Provider Entity Type
Organization
Address
1111 Gonder Av Se, Canton, OH, 44707
Phone Number
330-265-7902
Fax Number
Provider Enumeration Date
09/01/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1111 Gonder Av Se
City
Canton
State
Ohio
Zip
44707
Phone Number
330-265-7902
Fax Number
person
Provider Business Mailing Address Details
Address
1111 Gonder Av Se
City
Canton
State
Ohio
Zip
44707
Phone Number
330-265-7902
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
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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