Mahoning County Board of Mental Retardation and Developmental Disabili

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

MAHONING COUNTY BOARD OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILI

Practice address

4791 Woodridge Dr
Austintown, OH 44515-5115

Phone

(330) 797-2825

Fax

(330) 797-2843

NPI assigned

Mar 23, 2007

Last updated

Apr 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Larry Duck, MBA, MSW

Title

Superintendent

Phone

(330) 797-2828

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

County of Mahoning2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• County of Mahoning

  dba Mahoning County Health Department

  • State or Local Public Health Clinic/Center
  • Youngstown, OH
  • NPI 1235194937
  NPD tax ID

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1518084789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 WOODRIDGE DR",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445155115",
            "telephone_number": "330-797-2825",
            "fax_number": "330-797-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 WOODRIDGE DR",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445155115",
            "telephone_number": "330-797-2825",
            "fax_number": "330-797-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONING COUNTY BOARD OF MENTAL RETARDATION AND DEVELOPMENTAL DISABILI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "DUCK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "330-797-2828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, MSW"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0776110",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten Madick, OD
• Sarah Madunicky, CDCA
• Tashandi Magnus, CDCA
• Fatima Mahmood, DMD
• Erin Elizabeth Mahoney
• Mahoning Valley Hand Therapy
• Megan Maine
• Vincent Joseph Malkovits, D.O.
• Ginamarie Malleske, PHARMD
• John Manenti, DO

• Developmentally Disabled Services Day Training Agency in Austintown, OH
• Providers in Austintown, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.