Organization
ANNE GRADY DAY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN KING (EXECUTIVE DIRECTOR)
(419) 866-6500
Entity
Organization
Contact information
Practice address
1645 TRADE RD, HOLLAND, OH 43528-8204
(419) 866-6500
(419) 866-7457
Mailing address
1525 EBER RD, HOLLAND, OH 43528-9616
(419) 866-6500
(419) 866-7457
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251E00000X
Home Health Agency
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2696168
—
OH
05
—
2770130
—
OH
01
—
367657
MEDICARE
OH
05
—
4802897
—
OH
Enumeration date
11/21/2006
Last updated
04/15/2022
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