Organization
SPIRITHORSE OF OHIO, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANNIN DEHAVEN FORD (EXECUTIVE DIRECTOR)
(937) 536-9362
Entity
Organization
Contact information
Practice address
1800 GORDON RD, JAMESTOWN, OH 45335-9730
(937) 536-9362
Mailing address
1800 GORDON RD, JAMESTOWN, OH 45335-9730
(937) 536-9362
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/17/2021
Last updated
10/17/2021
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