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General NPI Number Information
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NPI Number | 1013122282
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Entity Type | Organization
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Legal Business Name | RICHWOOD RESIDENTIAL CENTERS, INC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 81 WALNUT ST
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City | GENEVA
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State | OH
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Zip | 44041-1829
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Country | US
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Telephone | 440-466-0733
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Fax | 440-466-0732
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Provider Business Mailing Address
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Address Line | 81 WALNUT ST P.O. BOX 769
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City | GENEVA
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State | OH
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Zip | 44041-1829
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Country | US
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Telephone | 440-466-0733
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Fax | 440-466-0732
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Authorized Official
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Title or Position | PRESIDENT
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Name | BILL STACHO
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Credential |
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Telephone | 440-466-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 0410237
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License Number State | OH
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