Organization
STONE LAKE DAYCARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BOWER RN (OWNER)
(614) 348-3888
Entity
Organization
Contact information
Practice address
144 N COLUMBUS ST, SUNBURY, OH 43074-9223
(614) 348-3888
Mailing address
144 N COLUMBUS ST, SUNBURY, OH 43074-9223
(614) 348-3888
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3008060
—
OH
Enumeration date
04/06/2016
Last updated
04/06/2016
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