South Street Icf

LBN: Anne Grady Corporation
South Street Icf is an health care organization with primary practice located at 1525 Eber Rd , Holland OH 43528-9616. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Anne Grady Corporation can be contacted via phone (419) 866-6500, or through King, Steven via phone (419) 866-6500.

Contact Information

Primary practice address
1525 Eber Rd Holland OH 43528-9616
Phone: (419) 866-6500
Fax: (419) 866-7457
Website:
Map and Directions
Authorized official contact:
Name: King, Steven
Phone: (419) 866-6500

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1528439932
LBN Legal business name Anne Grady Corporation
DBA Doing business as South Street Icf
Authorized official King, Steven
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2015
Last updated Apr 15th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528439932 NPPES
Ohio MEDICAID 0194828

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