Organization
SOUTH VIENNA GROUP HOMES, INC.
Active
Other names
Vienna Meadows
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN COLLERAN (PRESIDENT)
(440) 614-0160
Entity
Organization
Contact information
Practice address
125 EAST NATIONAL ROAD, SOUTH VIENNA, OH 45369-9742
(937) 568-4342
(937) 568-4265
Mailing address
22021 BROOKPARK RD, STE 123, FAIRVIEW PARK, OH 44126-3100
(440) 614-0160
(440) 614-0168
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2743615
—
OH
Enumeration date
05/04/2007
Last updated
10/22/2007
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