NPIMap

Organization Active NPI

Logan County Board of MRDD

  • Developmentally Disabled Services Day Training Agency
  • Bellefontaine, OH
National Provider Identifier
1841310653
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
4600015 Issued in OH
Legal business name
LOGAN COUNTY BOARD OF MRDD
Practice address
1851 State Route 47 W
Bellefontaine, OH 43311-9328
Phone
(937) 592-0015
Fax
(937) 592-5615
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph F Mancuso, PH.D.
Title
Superintendent
Phone
(937) 292-3009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 4600015 OH Primary

Addresses

Primary practice location

1851 State Route 47 W
Bellefontaine, OH 43311-9328

Mailing address

1851 State Route 47 W
Bellefontaine, OH 43311-9328
Phone (937) 592-0015

Other identifiers 1

IdentifierTypeStateIssuer
0776165MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
County of Logan Office of Auditor3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1851 State Route 47 W
Bellefontaine, OH 43311
Phone (937) 592-0015

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841310653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 STATE ROUTE 47 W",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433119328",
            "telephone_number": "937-592-0015",
            "fax_number": "937-592-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 STATE ROUTE 47 W",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433119328",
            "telephone_number": "937-592-0015",
            "fax_number": "937-592-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOGAN COUNTY BOARD OF MRDD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "937-292-3009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "4600015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0776165",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.