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General NPI Number Information
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NPI Number | 1619425873
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Entity Type | Organization
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Legal Business Name | MASCO, INC
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 160 MARWOOD CIR
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City | BOARDMAN
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State | OH
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Zip | 44512-6215
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Country | US
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Telephone | 330-797-2902
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Fax | 330-726-1522
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Provider Business Mailing Address
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Address Line | 160 MARWOOD CIR
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City | BOARDMAN
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State | OH
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Zip | 44512-6215
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Country | US
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Telephone | 330-797-2902
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Fax | 330-726-1522
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Authorized Official
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Title or Position | CEO
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Name | MR. PHILIP MILLER
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Credential |
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Telephone | 330-296-3996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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