Organization
OAK HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY JAMES KORMENDY (EXECUTIVE DIRECTOR)
(419) 734-4417
Entity
Organization
Contact information
Practice address
333A BUCKEYE BLVD, PORT CLINTON, OH 43452-1423
(419) 734-4417
(419) 734-4922
Mailing address
333A BUCKEYE BLVD, PORT CLINTON, OH 43452-1423
(419) 734-4417
(419) 734-4922
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0480
OH
Other
Enumeration date
06/06/2006
Last updated
08/22/2020
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