Organization
ADULT DEVELOPMENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD T MARTIN (CEO)
(330) 327-1696
Entity
Organization
Contact information
Practice address
1944 WHIPPLE AVE NW, CANTON, OH 44708-2841
(330) 327-1696
Mailing address
1944 WHIPPLE AVE NW, CANTON, OH 44708-2841
(330) 327-1696
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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