Provider Demographics
NPI:1720355399
Name:JOSIAH'S HOUSE INC.
Entity Type:Organization
Organization Name:JOSIAH'S HOUSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-236-6960
Mailing Address - Street 1:981 KEYNOTE CIR STE 13
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-1842
Mailing Address - Country:US
Mailing Address - Phone:216-236-6960
Mailing Address - Fax:
Practice Address - Street 1:981 KEYNOTE CIR STE 13
Practice Address - Street 2:
Practice Address - City:BROOKLYN HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44131-1842
Practice Address - Country:US
Practice Address - Phone:216-236-6960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3113384Medicaid