Mansfield Group Home, Ltd

NPI #1063409738 in Mansfield, Ohio

Provider Information

NPI Number
1063409738
Entity Type
Organization
Organization Name
Mansfield Group Home, Ltd
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Sep 28, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
245 W 4TH ST
State
Ohio
ZIP Code
44903-1704
Phone
(419) 524-2335

Authorized Official

Name
MRS. TRACY R ROBERTSON
Title
CORP. OFFICE EXECUTIVE ASSISTANT
Phone
(419) 526-0124

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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