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Organization

COUNTY OF RICHLAND

Active
Other names
Watts Group Home
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELIZABETH G PRATHER (SUPERINTENDENT)
(419) 774-4200
Entity
Organization

Contact information

Practice address
810 S MAIN ST, MANSFIELD, OH 44907-2038
(419) 774-4358
Mailing address
314 CLEVELAND AVE, MANSFIELD, OH 44902-8623
(419) 774-4200

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0116672
OH
Enumeration date
10/02/2007
Last updated
10/02/2007
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