Organization
SKYFALL RESIDENTIAL HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONYESHA FAGAN (OWNER)
(419) 214-9302
Entity
Organization
Contact information
Practice address
636 WAVERLY AVE, TOLEDO, OH 43607-3836
(419) 214-9302
Mailing address
636 WAVERLY AVE, TOLEDO, OH 43607-3836
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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