NPIMap

Organization Active NPI

Northwest Ohio Developmental Center

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Toledo, OH
National Provider Identifier
1497959605
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
NORTHWEST OHIO DEVELOPMENTAL CENTER
Practice address
1101 S Detroit Ave
Toledo, OH 43614-2704
Phone
(419) 385-0231
Fax
(419) 382-0719
NPI assigned
Jun 12, 2007
Last updated
Aug 24, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF OHIO - DEPARTMENT OF MRDDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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

Authorized official

Name
Ethel Hierholzer
Title
Operations Director
Phone
(419) 385-0231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X OH Primary

Addresses

Primary practice location

1101 S Detroit Ave
Toledo, OH 43614-2704

Mailing address

1101 S Detroit Ave
Toledo, OH 43614-2704
Phone (419) 385-0231

Other identifiers 1

IdentifierTypeStateIssuer
2411287MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031202000209 OH Part B Supplier - Clinic/Group Practice 0143133181 Receives reassigned benefits from 261 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Northfield, OH; Youngstown, OH; Toledo, OH; Tiffin, OH; Mt Vernon, OH; Mineral Ridge, OH; Massillon, OH; Huber Heights, OH…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497959605. Details of each certification follow.

  • CCN 36G593 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G593

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NORTHWEST OHIO DEVELOPMENTAL CENTER
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Aug 25, 2003
Last certification
Jul 31, 2025
Beds
80
Ownership / control type
State
Facility address
1101 South Detroit Avenue
Toledo, OH 43614

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2252739Northwest Ohio Developmental1101 South Detroit Ave, Toledo, OH 43614Certificate of waiverFeb 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Appalachian Psych Healt39 organizations share this tax ID, including this one
Part of
Appalachian Psych Healt

Other organizations with this tax ID 38

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

View all 38

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1497959605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 S DETROIT AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142704",
            "telephone_number": "419-385-0231",
            "fax_number": "419-382-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S DETROIT AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436142704",
            "telephone_number": "419-385-0231",
            "fax_number": "419-382-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OHIO DEVELOPMENTAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF OHIO - DEPARTMENT OF MRDD",
        "enumeration_date": "2007-06-12",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "HIERHOLZER",
        "authorized_official_first_name": "ETHEL",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "14193850231"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2411287",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.