Individual provider · Type 1 NPI
Charisse Lillian Ali
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Ashtabula, OH
Practice location
1440 W Prospect Rd
Ashtabula, OH 44004-6668
Fax (440) 998-5820
Mailing address
PO Box 548
Ashtabula, OH 44005-0548
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
2 other providers at this address
About NPI 1396331005
Charisse Lillian Ali's National Provider Identifier is 1396331005, issued on Dec 16, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Ashtabula, OH. The record was last updated on Dec 16, 2020.