Healthcare Provider Details

I. General information

NPI: 1629998950
Provider Name (Legal Business Name): MOUNT ALOYSIUS CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5375 TILE PLANT RD SE
NEW LEXINGTON OH
43764-9801
US

IV. Provider business mailing address

PO BOX 598
NEW LEXINGTON OH
43764-0598
US

V. Phone/Fax

Practice location:
  • Phone: 740-342-3343
  • Fax: 740-342-4805
Mailing address:
  • Phone: 740-342-3343
  • Fax: 740-342-4805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SHANNON JONES
Title or Position: ADMINISTRATOR/DOO
Credential:
Phone: 740-342-3343