Organization
MEDINA CREATIVE ACCESSIBILITY
Active
Parent organization
MEDINA CREATIVE HOUSING
Other names
Medina Creative Housing
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDINA CREATIVE HOUSING
Authorized official
MRS. DIANNE DEPASQUALE-HAGERTY (CHIEF EXECUTIVE OFFICER)
(330) 591-4434
Entity
Organization
Contact information
Practice address
224 N COURT ST, MEDINA, OH 44256-1980
(330) 591-4434
Mailing address
224 N COURT ST, MEDINA, OH 44256-1980
(330) 591-4434
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385HR2050X
Respite Care Camp
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5211265
—
OH
Enumeration date
09/29/2020
Last updated
09/29/2020
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