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Organization

CENTRAL OHIO GROUP HOMES, INC.

Active
Other names
Canterbury Villa
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN COLLERAN (PRESIDENT)
(440) 614-0160
Entity
Organization

Contact information

Practice address
80 MILLER ST, CENTERBURG, OH 43011-9741
(740) 625-6873
Mailing address
25000 COUNTRY CLUB BLVD, SUITE 255, NORTH OLMSTED, OH 44070-5344
(440) 614-0160
(440) 614-0168

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
4210642
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2417530
OH
Enumeration date
05/24/2005
Last updated
06/16/2014
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