Provider Demographics
NPI:1881730059
Name:AMDD,INC
Entity type:Organization
Organization Name:AMDD,INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:614-416-2638
Mailing Address - Street 1:2026 STATE ROUTE 45
Mailing Address - Street 2:
Mailing Address - City:AUSTINBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44010-9711
Mailing Address - Country:US
Mailing Address - Phone:440-239-4300
Mailing Address - Fax:440-239-4301
Practice Address - Street 1:2026 STATE ROUTE 45
Practice Address - Street 2:
Practice Address - City:AUSTINBURG
Practice Address - State:OH
Practice Address - Zip Code:44010-9711
Practice Address - Country:US
Practice Address - Phone:440-239-4300
Practice Address - Fax:440-239-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2083310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility