Organization
AIW
Active
Organization
AIW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE WALTON (MEMBER)
(216) 539-6314
Entity
Organization
Contact information
Practice address
20706 BOWLING GREEN RD, MAPLE HEIGHTS, OH 44137-3104
(216) 539-6314
Mailing address
20706 BOWLING GREEN RD, MAPLE HEIGHTS, OH 44137-3104
(216) 539-6314
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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