Healthcare Provider Details

I. General information

NPI: 1841542016
Provider Name (Legal Business Name): GOOD ORDERLY DIRECTION HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 RENWYCK DR D
TOLEDO OH
43615-5973
US

IV. Provider business mailing address

5250 RENWYCK DR D
TOLEDO OH
43615-5973
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-9550
  • Fax: 419-720-9355
Mailing address:
  • Phone: 419-720-9550
  • Fax: 419-720-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. ROBIN MCCANT
Title or Position: CEO
Credential:
Phone: 419-720-9550