Provider Demographics
NPI:1295761906
Name:QUADCO REHABILITATION CENTER
Entity type:Organization
Organization Name:QUADCO REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FRUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-682-1011
Mailing Address - Street 1:427 N DEFIANCE ST
Mailing Address - Street 2:
Mailing Address - City:STRYKER
Mailing Address - State:OH
Mailing Address - Zip Code:43557-9472
Mailing Address - Country:US
Mailing Address - Phone:419-682-1011
Mailing Address - Fax:419-682-5601
Practice Address - Street 1:427 N DEFIANCE ST
Practice Address - Street 2:
Practice Address - City:STRYKER
Practice Address - State:OH
Practice Address - Zip Code:43557-9472
Practice Address - Country:US
Practice Address - Phone:419-682-1011
Practice Address - Fax:419-682-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0098251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10147Medicare UPIN