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General NPI Number Information
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NPI Number | 1275686602
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Entity Type | Organization
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Legal Business Name | TIFFIN DEVELOPMENTAL CENTER
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 600 N RIVER RD
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City | TIFFIN
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State | OH
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Zip | 44883-1173
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Country | US
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Telephone | 419-447-1450
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Fax | 419-448-6506
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Provider Business Mailing Address
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Address Line | 600 N RIVER RD
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City | TIFFIN
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State | OH
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Zip | 44883-1173
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Country | US
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Telephone | 419-447-1450
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Fax | 419-448-6506
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Authorized Official
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Title or Position | ACCOUNT CLERK
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Name | MRS. LOIS M MCQUISTION
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Credential |
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Telephone | 419-447-1450
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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 | 36G588
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License Number State | OH
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