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SOUTH STREET ICF
NPI 1528439932
Intermediate Care Facility, Intellectual Disabilities in Holland, OH

Active since October 12, 2015
1525 EBER RD, HOLLAND, OH 43528(419) 866-6500(419) 866-7457 Get Directions Write a Review

NPPES record last updated: April 15, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Apr 15, 2022, Sep 25, 2018 (2 updates tracked since 2018).

About South Street Icf NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH STREET ICF (NPI 1528439932) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Holland, Ohio and active in the NPI registry since October 2015. The organization lists Steven King, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1528439932
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameANNE GRADY CORPORATION
Location Address1525 EBER RDHolland, OH 43528-9616
Mailing AddressPo Box 1297Holland, OH 43528-1297 · (419) 866-6500 · Fax (419) 866-7457
Phone(419) 866-6500
Fax(419) 866-7457
Organization SubpartNo
Authorized OfficialSteven KingExecutive Director · (419) 866-6500
Enumeration DateOctober 12, 2015
Last NPPES UpdateApril 15, 20222 updates tracked since enumeration
NPPES CertifiedApril 15, 2022
✔ NPI 1528439932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1525 EBER RD, Holland, OH 43528
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Other Names 1

Other NameSouth Street Icf

Other Identifiers 1

Medicaid0194828OH

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. COLLEEN CATHERINE TYE L.P.T.
Physical Therapist
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
JEREMY KESTNER
Physical Therapy Assistant
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
JANE MARIE FORTENER OTR/L
Occupational Therapist
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
ANNE GRADY CORPORATION
Clinic/Center (Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF))
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
ANNE GRADY CORPORATION
Clinic/Center (Physical Therapy)
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
CHRISTINE MARIAN KUDLAK SLP
Speech-Language Pathologist
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500
LIFESOURCE OF NORTH CAROLINA
Social Worker (Clinical)
1525 EBER RD
HOLLAND, OH 43528
Lucas County (910) 742-9243
ANNE GRADY CORPORATION
Intermediate Care Facility, Intellectual Disabilities
1525 EBER RD
HOLLAND, OH 43528
Lucas County (419) 866-6500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Anne Grady Corporation's NPI number?

The NPI number for Anne Grady Corporation is 1528439932. It was assigned to this organization in the NPPES registry on October 12, 2015. The provider is also known as South Street Icf.

Where is Anne Grady Corporation located?

Anne Grady Corporation is located at 1525 Eber Rd, Holland, OH 43528. The listed phone number is (419) 866-6500.

What is Anne Grady Corporation's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Anne Grady Corporation was last updated on April 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.