Organization
KENDRA'S HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA DIDION (EXECUTIVE DIRECTOR)
(419) 656-9074
Entity
Organization
Contact information
Practice address
4317 STATE ROUTE 269 S, CASTALIA, OH 44824-9354
(419) 656-9074
Mailing address
4317 STATE ROUTE 269 S, CASTALIA, OH 44824-9354
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0247217
—
OH
Enumeration date
01/23/2018
Last updated
01/23/2018
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