Healthcare Provider Details

I. General information

NPI: 1639327760
Provider Name (Legal Business Name): REM OHIO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 RAINBOW DR NW
LANCASTER OH
43130-8523
US

IV. Provider business mailing address

470 PORTAGE LAKES DR STE 206
COVENTRY TOWNSHIP OH
44319-2296
US

V. Phone/Fax

Practice location:
  • Phone: 614-367-1370
  • Fax: 614-367-9751
Mailing address:
  • Phone: 330-644-5216
  • Fax: 330-644-5475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number0840077
License Number StateOH

VIII. Authorized Official

Name: BRETT IAN COHEN
Title or Position: COO
Credential:
Phone: 800-388-5150