Provider Demographics
NPI:1073116711
Name:OHIO TEACHING FAMILY ASSOCIATION
Entity Type:Organization
Organization Name:OHIO TEACHING FAMILY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-825-3440
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-0300
Mailing Address - Country:US
Mailing Address - Phone:419-825-3440
Mailing Address - Fax:
Practice Address - Street 1:4020 WATERVILLE SWANTON RD
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8963
Practice Address - Country:US
Practice Address - Phone:419-825-3440
Practice Address - Fax:419-825-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities