Organization
JOB AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTI LYNNE GATES (LPN NURSE)
(740) 501-2198
Entity
Organization
Contact information
Practice address
106 S ROGERS ST, MOUNT VERNON, OH 43050-3643
(740) 501-2198
Mailing address
106 S ROGERS ST, MOUNT VERNON, OH 43050-3643
(740) 501-2198
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PN-114978
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2725500
—
OH
Enumeration date
04/24/2008
Last updated
04/24/2008
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