Healthcare Provider Details

I. General information

NPI: 1447851456
Provider Name (Legal Business Name): THE GOODWILL INDUSTRIES OF AKRON, OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 E WATERLOO RD
AKRON OH
44319-1223
US

IV. Provider business mailing address

570 E WATERLOO RD
AKRON OH
44319-1223
US

V. Phone/Fax

Practice location:
  • Phone: 330-801-7022
  • Fax:
Mailing address:
  • Phone: 330-801-7022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARSHA ROYAL
Title or Position: MANAGER OF MISSION AND CAREER SERV
Credential:
Phone: 330-801-7022