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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