NPI 1063409738

Mansfield Group Home, LTD

Organisation Intellectual Disabilities Intermediate Care Facility Mansfield, OH

Practice location

Address: 245 W 4th St, Mansfield, OH 44903-1704
Phone: (419) 524-2335
Fax: (419) 522-4391

Authorised official

Name: Tracy R Robertson
Title: Corp. Office Executive Assistant
Phone: (419) 526-0124

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 15636 (OH)

Other Intermediate Care Facility, Intellectual Disabilities providers in Ohio →

Registry record

NPI: 1063409738
Entity type: Organization
NPI issued: 28 Sep 2005
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.