Provider Demographics
NPI:1962852244
Name:ALZHEIMER'S AND DEMENTIA CARE SERVICES OF NORTHWESTERN OHIO
Entity Type:Organization
Organization Name:ALZHEIMER'S AND DEMENTIA CARE SERVICES OF NORTHWESTERN OHIO
Other - Org Name:MEMORYLANE CARE SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:419-720-4940
Mailing Address - Street 1:2500 N REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-0708
Mailing Address - Country:US
Mailing Address - Phone:419-537-1999
Mailing Address - Fax:419-536-5591
Practice Address - Street 1:2500 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-0708
Practice Address - Country:US
Practice Address - Phone:419-537-1999
Practice Address - Fax:419-536-5591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251V00000XAgenciesVoluntary or Charitable
No385H00000XRespite Care FacilityRespite Care