Organization
PEGASUS FARM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN LAYTON (ADULT SERVICES DIRECTOR)
(330) 935-2300
Entity
Organization
Contact information
Practice address
7490 EDISON ST NE, HARTVILLE, OH 44632-9328
(330) 935-2300
(330) 935-0620
Mailing address
7490 EDISON ST NE, HARTVILLE, OH 44632-9328
(330) 935-2300
(330) 935-0620
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3118263
—
OH
Enumeration date
12/11/2020
Last updated
12/11/2020
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