Provider Demographics
NPI:1972981454
Name:TOWARD INDEPENDENCE INC.
Entity type:Organization
Organization Name:TOWARD INDEPENDENCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHLATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-376-3996
Mailing Address - Street 1:81 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-3201
Mailing Address - Country:US
Mailing Address - Phone:937-376-3996
Mailing Address - Fax:
Practice Address - Street 1:1620 SOUTHLAWN DR
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-3938
Practice Address - Country:US
Practice Address - Phone:937-376-3996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2910229315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2121993Medicaid