Provider Demographics
NPI:1366137531
Name:GOODWILL INDUSTRIES OF ERIE, HURON, OTTAWA & SANDUSKY COUNTIES, INC.
Entity type:Organization
Organization Name:GOODWILL INDUSTRIES OF ERIE, HURON, OTTAWA & SANDUSKY COUNTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MISSION SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-625-4744
Mailing Address - Street 1:419 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-2411
Mailing Address - Country:US
Mailing Address - Phone:419-625-4744
Mailing Address - Fax:419-625-4692
Practice Address - Street 1:419 W MARKET ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-2411
Practice Address - Country:US
Practice Address - Phone:419-625-4744
Practice Address - Fax:419-625-4692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services