Organization
599 WEST MAIN CORPORATION
Active
Other names
Homestead
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER MICHAEL TOST (ATTORNEY/CHIEF LEGAL OFFICER)
(216) 682-2118
Entity
Organization
Contact information
Practice address
599 WEST MAIN ST., GENEVA, OH 44041
(440) 466-1079
(440) 466-2081
Mailing address
599 WEST MAIN ST., PO BOX 69, GENEVA, OH 44041
(440) 466-1079
(440) 466-2081
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1387
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0378336
—
OH
Enumeration date
05/03/2007
Last updated
12/31/2018
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