Provider Demographics
NPI:1013126176
Name:MEDINA COUNTY SHELTERED INDUSTRIES, INC.
Entity Type:Organization
Organization Name:MEDINA COUNTY SHELTERED INDUSTRIES, INC.
Other - Org Name:WINDFALL INDUSTRIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR-CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:330-334-4491
Mailing Address - Street 1:150 QUADRAL DR STE D
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8352
Mailing Address - Country:US
Mailing Address - Phone:330-334-4491
Mailing Address - Fax:330-334-4492
Practice Address - Street 1:150 QUADRAL DR STE D
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8352
Practice Address - Country:US
Practice Address - Phone:330-334-4491
Practice Address - Fax:330-334-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2480328Medicaid
OH5201552Medicaid