Organization
SELF-DIRECTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN POZDERAC (DIRECTOR/OWNER)
(330) 273-5494
Entity
Organization
Contact information
Practice address
6721 GRAFTON RD, VALLEY CITY, OH 44280-9705
(330) 273-5494
Mailing address
6721 GRAFTON RD, VALLEY CITY, OH 44280-9705
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119312
—
OH
Enumeration date
06/01/2015
Last updated
06/01/2015
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