Organization
SELF RELIANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAY A CRAWFORD (PRESIDENT)
(937) 525-0809
Entity
Organization
Contact information
Practice address
1307 E. HIGH ST., SPRINGFIELD, OH 45505-4245
(937) 525-0809
(937) 525-9027
Mailing address
1307 E. HIGH ST., SPRINGFIELD, OH 45505-4245
(937) 525-0809
(937) 525-9027
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1200775
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1200775
OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES
OH
Enumeration date
09/19/2012
Last updated
09/19/2012
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