Organization
MIDWEST INNOVATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM RICKELS (CEO)
(330) 832-9582
Entity
Organization
Contact information
Practice address
11 LINCOLN WAY W, SUITE 5A, MASSILLON, OH 44647-6585
(330) 832-9582
(330) 833-7732
Mailing address
11 LINCOLN WAY W, SUITE 5A, MASSILLON, OH 44647-6585
(330) 832-9582
(330) 833-7732
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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