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Organization

599 WEST MAIN CORPORATION

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Other names
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Organization subpart
No

Provider details

NPI number
Authorized official
JAMES E. MILLER III (PRESIDENT)
(440) 466-1079
Entity
Organization

Contact information

Practice address
609 WEST MAIN STREET, GENEVA, OH 44041
(440) 466-7763
Mailing address
PO BOX 69, GENEVA, OH 44041-0069

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
02/11/2019
Last updated
02/11/2019
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