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General NPI Number Information
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NPI Number | 1396752267
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Entity Type | Organization
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Legal Business Name | VALLEY HOUSE
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 544 COLUMBIA RD
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City | VALLEY CITY
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State | OH
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Zip | 44280-9755
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Country | US
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Telephone | 330-273-5494
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Fax | 330-273-6199
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Provider Business Mailing Address
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Address Line | 791 PEARL RD
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City | BRUNSWICK
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State | OH
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Zip | 44212-2528
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Country | US
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Telephone | 330-273-5494
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Fax | 330-273-6199
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | DENISE T POZDERAC
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Credential | LNHA
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Telephone | 330-273-5494
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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 | 5210275
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License Number State | OH
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