Organization
GROUP ONE 20 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESA KING (OWNER)
(216) 571-8564
Entity
Organization
Contact information
Practice address
22711 NICHOLAS AVE, EUCLID, OH 44123-3257
(216) 571-8564
Mailing address
22711 NICHOLAS AVE, EUCLID, OH 44123-3257
(216) 571-8564
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0408563
—
OH
Enumeration date
11/29/2020
Last updated
11/29/2020
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