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Organization
OAK GROVE MANOR MRDD
Active
Organization
OAK GROVE MANOR MRDD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSCAR G ALEMAN (CONTROLLER)
(614) 459-2482
Entity
Organization
Contact information
Practice address
1670 CRIDER RD, MANSFIELD, OH 44903-9268
(614) 459-2482
(614) 459-2641
Mailing address
1661 OLD HENDERSON RD, COLUMBUS, OH 43220-3644
(614) 459-2482
(614) 459-2641
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1783N
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2561464
—
OH
Enumeration date
03/01/2007
Last updated
08/22/2020
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