Organization
LIFE OUT LOUD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LISA ANN COOPER M. ED. (CEO)
(440) 413-0086
Entity
Organization
Contact information
Practice address
904 1/2 WEST WASHINGTON STREET, SANDUSKY, OH 44870
(419) 502-2037
(419) 502-2036
Mailing address
904 1/2 WEST WASHINGTON STREET, SANDUSKY, OH 44870
(440) 413-0086
(419) 502-2036
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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