Organization
SAMUEL HOUSE
Active
Parent organization
TRANSITIONAL LIVING CENTERS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRANSITIONAL LIVING CENTERS, INC.
Authorized official
DENISE T POZDERAC LNHA (PRESIDENT/ADMINISTRATOR)
(330) 273-5494
Entity
Organization
Contact information
Practice address
2088 SAMUEL DR, BRUNSWICK, OH 44212-4149
(330) 273-5494
(330) 273-6199
Mailing address
791 PEARL RD, BRUNSWICK, OH 44212-2528
(330) 273-5494
(330) 273-6199
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
5210239
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0159439
—
OH
05
—
36-G505
—
OH
Enumeration date
08/04/2006
Last updated
07/12/2007
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