Organization
ANNE GRADY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN KING (EXECUTIVE DIRECTOR)
(419) 866-6500
Entity
Organization
Contact information
Practice address
1525 EBER RD, HOLLAND, OH 43528-9616
(419) 866-6500
(419) 866-7457
Mailing address
1525 EBER RD, HOLLAND, OH 43528-9616
(419) 866-6500
(419) 866-7457
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0523768
OH
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4800139
OH
343900000X
Non-emergency Medical Transport (VAN)
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
0523768
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0523768
—
OH
05
—
4800139
—
OH
Enumeration date
10/23/2006
Last updated
04/15/2022
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