Organization
GENTLEBROOK
Active
Other names
Lafayette Meadows Family Home
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DEAN SLEUTZ LSW, QDDP (CHIEF OPERATING OFFICER)
(330) 877-7700
Entity
Organization
Contact information
Practice address
21632 PICKWICK ST, BOX 30, WEST LAFAYETTE, OH 43845-9511
(740) 545-6366
Mailing address
880 SUNNYSIDE ST SW, HARTVILLE, OH 44632-9087
(330) 877-7700
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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