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NPI Profile for DETRA REYNOLDS TODD in AVON, IN.
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Respite Care, Intellectual and/or Developmental Disabilities |
385HR2060X |
| NPI # | 1477299691 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/10/2022 | |
| Last updated | 08/09/2023 - About 3 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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DETRA REYNOLDS TODD
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DETRA REYNOLDS TODD