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Organization

THOMAS HOME

Active
Parent organization
OUR LADY OF THE WAYISDE
Organization subpart
Yes

Provider details

NPI number
Legal business name
OUR LADY OF THE WAYISDE
Authorized official
SHIRLEY SHARP (BUSINESS ADMINISTRATOR)
(440) 934-6152
Entity
Organization

Contact information

Practice address
38135 COLORADO AVE, AVON, OH 44011-1028
(440) 934-6152
Mailing address
38135 COLORADO AVE, AVON, OH 44011-1028

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
4710838
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2927668
OH
Enumeration date
04/14/2011
Last updated
04/14/2011
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