Healthcare Provider Details

I. General information

NPI: 1720207574
Provider Name (Legal Business Name): MANAHAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S HOLLAND SYLVANIA RD
TOLEDO OH
43615-5622
US

IV. Provider business mailing address

120 S. HOLLAND SYLVANIA RD.
TOLEDO OH
43615-5622
US

V. Phone/Fax

Practice location:
  • Phone: 419-866-9013
  • Fax: 419-866-8428
Mailing address:
  • Phone: 419-866-9013
  • Fax: 419-866-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN MAENLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-866-9013