NPIMap

Organization Active NPI

Cuyahoga County Board of Developmental Disabilities

  • Case Management Agency
  • Cleveland, OH
National Provider Identifier
1144825969
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
CUYAHOGA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES
Practice address
1275 Lakeside Ave., E.
Cleveland, OH 44114
Phone
(216) 241-8230
Fax
(216) 861-0253
NPI assigned
Dec 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kelly Petty
Title
Superintendent
Phone
(216) 736-2731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1275 Lakeside Ave., E.
Cleveland, OH 44114

Mailing address

1275 Lakeside Ave., E.
Cleveland, OH 44114
Phone (216) 241-8230

Other identifiers 1

IdentifierTypeStateIssuer
1800019MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
County of Cuyahoga47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1144825969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 LAKESIDE AVE., E.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-241-8230",
            "fax_number": "216-861-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 LAKESIDE AVE., E.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44114",
            "telephone_number": "216-241-8230",
            "fax_number": "216-861-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUYAHOGA COUNTY BOARD OF DEVELOPMENTAL DISABILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "216-736-2731",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1800019",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.