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ANNE GRADY CORPORATION

Intermediate Care Mentally Retarded

Toledo, Ohio

Provider NPI: 1114172905

Organization Information:
Organization Name:  ANNE GRADY CORPORATION
Organization is not Subpart
Authorized Official:  ROGER  FORTENER  ASSOC EXECUTIVE DIRECTOR  419-8666500

Practice Location:
5923 EVERWOOD RD  TOLEDO, OH 43613 US
Tel: 419-866-6500  Fax: 419-866-7457

Business Mailing Address:
1525 EBER RD  HOLLAND, OH 43528 US
Tel: 419-866-6500  Fax: 419-866-7457

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded

Other Provider Identifiers:

IssuerNumberStateType
0919804OH05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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