Provider Demographics
NPI:1699051797
Name:N.A.O.M.I.
Entity type:Organization
Organization Name:N.A.O.M.I.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:TISDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-244-4824
Mailing Address - Street 1:PO BOX 9397
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43697-9397
Mailing Address - Country:US
Mailing Address - Phone:419-244-4824
Mailing Address - Fax:419-244-4825
Practice Address - Street 1:2321 WARREN ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1320
Practice Address - Country:US
Practice Address - Phone:419-244-4824
Practice Address - Fax:419-244-4825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13003324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility