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Organization

TEACHING EXCELLENCE

Active
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Organization

TEACHING EXCELLENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SIDNEY LAMAR GLOVER JR. (OPERATIONS MANAGER)
(330) 979-9854
Entity
Organization

Contact information

Practice address
1102 WOOD AVE SW, WARREN, OH 44485-3865
(330) 979-9854
Mailing address
1102 WOOD AVE SW, WARREN, OH 44485-3865
(330) 979-9854

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
OH
251E00000X
Home Health Agency
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102311
OH
Enumeration date
05/14/2014
Last updated
05/14/2014
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