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Organization
SHALOM HOUSE SOUTH
Active
Organization
SHALOM HOUSE SOUTH
Active
Other names
Shalom House Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH DODGE QMRP (ADMINISTRATOR)
(614) 239-1999
Entity
Organization
Contact information
Practice address
1480 COLLEGE AVE, COLUMBUS, OH 43209-2888
(614) 338-2351
(614) 338-2353
Mailing address
1480 COLLEGE AVE, COLUMBUS, OH 43209-2888
(614) 338-2351
(614) 338-2353
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2512963
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0899201
—
OH
Enumeration date
04/17/2006
Last updated
08/22/2020
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