36D2214958 CLIA NUMBER - RESCARE - BLACK OAK

Laboratory Demographics

CLIA Number: 36D2214958

Facility Name: RESCARE - BLACK OAK

Facility Address:
41134 BLACK OAK RD
FLUSHING, OH
ZIP 43977
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Facility Phone Number: 513 460-1708

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1578751830

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	36D2214958
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	RESCARE - BLACK OAK
Street	41134 BLACK OAK RD
City	FLUSHING
State	OH
ZIP	43977
Phone	513 460-1708
CertificateType	4
CertificateEffectiveDate	2/25/2023
CertificateExpirationDate	2/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024