Provider Demographics
NPI:1598889305
Name:AUGLAIZE INDUSTRIES, INC.
Entity type:Organization
Organization Name:AUGLAIZE INDUSTRIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADULT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-629-3603
Mailing Address - Street 1:330 W. BOESEL AVE.
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45885-1311
Mailing Address - Country:US
Mailing Address - Phone:419-629-3603
Mailing Address - Fax:419-629-3983
Practice Address - Street 1:330 W BOESEL AVE
Practice Address - Street 2:
Practice Address - City:NEW BREMEN
Practice Address - State:OH
Practice Address - Zip Code:45869-1311
Practice Address - Country:US
Practice Address - Phone:419-629-3603
Practice Address - Fax:419-629-3983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0860126251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0860126Medicaid