Healthcare Provider Details

I. General information

NPI: 1942140660
Provider Name (Legal Business Name): GOATS ADULT DAY SUPPORT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26903 BUTTERNUT RIDGE RD
NORTH OLMSTED OH
44070-4411
US

IV. Provider business mailing address

26903 BUTTERNUT RIDGE RD
NORTH OLMSTED OH
44070-4411
US

V. Phone/Fax

Practice location:
  • Phone: 440-850-9236
  • Fax:
Mailing address:
  • Phone: 440-850-9236
  • 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

VIII. Authorized Official

Name: SERENA WILLIAMS
Title or Position: OWNER
Credential:
Phone: 440-850-9236