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Organization
SOUTH VIENNA GROUP HOMES, INC.
Active
Organization
SOUTH VIENNA GROUP HOMES, INC.
Active
Other names
Vienna Meadows
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN COLLERAN (PRESIDENT)
(440) 614-0160
Entity
Organization
Contact information
Practice address
125 EAST NATIONAL ROAD, SOUTH VIENNA, OH 45369-9742
(937) 568-4342
(937) 568-4265
Mailing address
22021 BROOKPARK RD, STE 123, FAIRVIEW PARK, OH 44126-3100
(440) 614-0160
(440) 614-0168
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2743615
—
OH
Enumeration date
05/04/2007
Last updated
10/22/2007
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