Organization
PHOENIX RESIDENTIAL CENTERS, INC.
Active
Other names
Lockwood Family Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JO JASKELA (CONTROLLER)
(440) 428-9082
Entity
Organization
Contact information
Practice address
5278 LOCKWOOD RD, MADISON, OH 44057-2313
(440) 428-0318
Mailing address
1954 HUBBARD RD, P.O. BOX 40, MADISON, OH 44057-2172
(440) 428-9082
(440) 428-5399
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/27/2013
Last updated
07/21/2022
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