IndividualActive
Antonia Bolar
NPI 1790505220 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bedford Hts, OH
Provider details
- NPI number
- 1790505220
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
409 Center Rd Apt 3
Bedford Hts, OH 44146-2262
Phone: (216) 854-5969
Approximate (ZIP-level) locationGet directions
Mailing address
409 Center Rd Apt 3
Bedford Hts, OH 44146-2262
Registry dates
- Enumerated
- 2024-10-10
- Last updated
- 2024-10-10
- Certified
- 2024-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.