NPIMap

Organization Active NPI

Lawrence County Board of Mental Retardation Development Disabilities

  • Developmentally Disabled Services Day Training Agency
  • Coal Grove, OH
National Provider Identifier
1699983775
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
0773042 Issued in OH
Legal business name
LAWRENCE COUNTY BOARD OF MENTAL RETARDATION DEVELOPMENT DISABILITIES
Practice address
604 Carlton Davidson LN
Coal Grove, OH 45638-2926
Phone
(740) 532-7401
NPI assigned
May 20, 2007
Last updated
Apr 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Paul B. Mollett
Title
Superintendent
Phone
(740) 532-7401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 0773042 OH Primary

Addresses

Primary practice location

604 Carlton Davidson LN
Coal Grove, OH 45638-2926

Mailing address

604 Carlton Davidson LN
Coal Grove, OH 45638-2926

Other identifiers 1

IdentifierTypeStateIssuer
0642399MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Lawrence County EMS4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1699983775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 CARLTON DAVIDSON LN",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "456382926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 CARLTON DAVIDSON LN",
            "city": "COAL GROVE",
            "state": "OH",
            "postal_code": "456382926",
            "telephone_number": "740-532-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE COUNTY BOARD OF MENTAL RETARDATION DEVELOPMENT DISABILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "MOLLETT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "740-532-7401"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "0773042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0642399",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coal Grove, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.