Organization
DEPT OF JOBS AND FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE L MULDER (LPN)
(419) 261-9141
Entity
Organization
Contact information
Practice address
211 VALLEYWOODS DR # B, SWANTON, OH 43558-1047
(419) 261-9141
Mailing address
211 B VALLEYWOODS DR., SWANTON, OH 43558-8955
(419) 261-9141
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PN068879
OH
Other
Enumeration date
05/18/2007
Last updated
08/08/2008
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