Healthcare Provider Details

I. General information

NPI: 1558281303
Provider Name (Legal Business Name): E.C.I.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2036 E TOWNSHIP ROAD 122
TIFFIN OH
44883-8766
US

IV. Provider business mailing address

2036 E TOWNSHIP ROAD 122
TIFFIN OH
44883-8766
US

V. Phone/Fax

Practice location:
  • Phone: 419-443-0767
  • Fax:
Mailing address:
  • Phone: 419-443-0767
  • 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 State

VIII. Authorized Official

Name: LAURA WITHROW
Title or Position: PRESIDENT
Credential:
Phone: 419-443-0767