Provider Demographics
NPI:1316334642
Name:MCINTOSH HOUSE INC
Entity type:Organization
Organization Name:MCINTOSH HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:MARLINE
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:419-944-7419
Mailing Address - Street 1:3202 CHELTENHAM RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1818
Mailing Address - Country:US
Mailing Address - Phone:419-944-7419
Mailing Address - Fax:
Practice Address - Street 1:3202 CHELTENHAM RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1818
Practice Address - Country:US
Practice Address - Phone:419-944-7419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068847Medicaid