OUR LADY OF THE WAYSIDE NPI 1306069752

NPI Information

NPI: 1306069752
Provider Name: OUR LADY OF THE WAYSIDE
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
38135 COLORADO AVE
AVON, OH
ZIP 44011
Phone: (440) 934-6007
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OUR LADY OF THE WAYSIDE is a residential treatment facility, intellectual and/or developmental disabilities in Avon, OH. The provider is 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. OUR LADY OF THE WAYSIDE NPI is 1306069752. The provider is registered as an organization entity type.

The provider's business location address is:

38135 COLORADO AVE
AVON, OH
ZIP 44011-028
Phone: (440) 934-6007
Fax: (440) 934-6327

The provider's authorized official is Terry Davis .
The authorized official title is Ceo and has the following contact phone number (440) 934-6007.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 8/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		4700514	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4700514	OTHER	OHIO	OUR LADY OF THE WAYSIDE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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