Organization
GUADALUPE HOME
Active
Parent organization
OUR LADY OF THE WAYSIDE
Organization subpart
Yes
Provider details
NPI number
Legal business name
OUR LADY OF THE WAYSIDE
Authorized official
MRS. SHIRLEY SHARP (BUSINESS ADMINISTRATOR)
(440) 934-6152
Entity
Organization
Contact information
Practice address
38023 COLORADO AVE, AVON, OH 44011-1026
(440) 934-4825
(440) 934-4799
Mailing address
38135 COLORADO AVE, AVON, OH 44011-1028
(440) 934-6152
(440) 934-0430
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
4710076
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0870026
—
OH
Enumeration date
10/07/2008
Last updated
10/07/2008
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