Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Individual

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1962958512

Individual is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Canton, Ohio. Registered with an NPI since 2016.

In the registry since
2016

Practice location Address checks out

1111 Gonder Ave SE
Canton, OH 44707
Phone: (330) 265-7902
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X

Record details

NPI number1962958512
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tammie Mayle — Home Health Aid · (330) 265-7902
NPI enumeratedSeptember 1, 2016
Last updated in NPPESSeptember 1, 2016
Mailing address1111 Gonder Av Se, Canton, OH 44707

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