Provider Demographics
NPI:1508088923
Name:SPIRES RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:SPIRES RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPIRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-382-0940
Mailing Address - Street 1:2810 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2505
Mailing Address - Country:US
Mailing Address - Phone:419-382-0940
Mailing Address - Fax:419-380-8514
Practice Address - Street 1:2810 GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2505
Practice Address - Country:US
Practice Address - Phone:419-382-0940
Practice Address - Fax:419-380-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4802762251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4802762Medicaid