Healthcare Provider Details

I. General information

NPI: 1154234235
Provider Name (Legal Business Name): ATWOOD HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 2ND ST
DILLONVALE OH
43917-7802
US

IV. Provider business mailing address

184 2ND ST
DILLONVALE OH
43917-7802
US

V. Phone/Fax

Practice location:
  • Phone: 740-769-7643
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: ASHLEY KEMPTON
Title or Position: DOO
Credential:
Phone: 740-769-7643