NPI 1306069752
Our Lady of the Wayside
Practice location
- Address
- 38135 Colorado Ave, Avon, OH 44011-1028
- Phone
- (440) 934-6007
- Fax
- (440) 934-6327
Authorised official
- Name
- Terry Davis
- Title
- Ceo
- Phone
- (440) 934-6007
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1306069752
- Entity type
- Organization
- NPI issued
- 11 Apr 2007
- Record last updated
- 29 Aug 2008
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.