Provider Demographics
NPI:1912512021
Name:METZENBAUM SHELTERED INDUSTRIES, INC.
Entity Type:Organization
Organization Name:METZENBAUM SHELTERED INDUSTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-272-2515
Mailing Address - Street 1:8090 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-3465
Mailing Address - Country:US
Mailing Address - Phone:440-729-1919
Mailing Address - Fax:440-729-1910
Practice Address - Street 1:8090 CEDAR RD
Practice Address - Street 2:
Practice Address - City:CHESTERLAND
Practice Address - State:OH
Practice Address - Zip Code:44026-3465
Practice Address - Country:US
Practice Address - Phone:440-729-1919
Practice Address - Fax:440-729-1910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH261QA0600XMedicaid
OH251C00000XMedicaid
OH343900000XMedicaid