Organization
NORTHEAST DEVELOPMENTAL SERVICES, INCORPORATED
Active
Organization
NORTHEAST DEVELOPMENTAL SERVICES, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY POWELL (PRESIDENT)
(330) 495-6374
Entity
Organization
Contact information
Practice address
7790 MARKET AVE N, CANTON, OH 44721-1641
(330) 495-6374
Mailing address
7790 MARKET AVE N, CANTON, OH 44721-1641
(330) 495-6374
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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