Organization
SPARK LLC
Active
Organization
SPARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY A LANEY (OWNER)
(740) 334-0657
Entity
Organization
Contact information
Practice address
10714 ZARTMAN RD, THORNVILLE, OH 43076-9202
(740) 334-0657
Mailing address
10714 ZARTMAN RD, THORNVILLE, OH 43076-9202
(740) 334-0657
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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