Organization
PEGASUS FREEDOM REINS OHIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JO REILLY-PANICCIA (OWNER)
(937) 707-0050
Entity
Organization
Contact information
Practice address
16090 HAWN RD, PLAIN CITY, OH 43064-9730
(937) 707-0050
Mailing address
PO BOX 174, UNIONVILLE CENTER, OH 43077-0174
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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