Healthcare Provider Details

I. General information

NPI: 1417544438
Provider Name (Legal Business Name): GREEN OPTIONS FOR AUTISM OF LUCAS COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 AMESBURY RD
TOLEDO OH
43612-2007
US

IV. Provider business mailing address

1660 AMESBURY RD
TOLEDO OH
43612-2007
US

V. Phone/Fax

Practice location:
  • Phone: 419-720-4350
  • Fax:
Mailing address:
  • Phone: 419-720-4350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MRS. BARBARA JEAN SABIN
Title or Position: DIRECTOR
Credential:
Phone: 419-250-4010