Hattie Larlham Center for Children With Disablilites
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Mantua, OH
NPI 1982876504 · NPPES record last updated Jan 31, 2020
Key facts
- NPI
- 1982876504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- License
- 0269874 (OH)
- Legal business name
- HATTIE LARLHAM CENTER FOR CHILDREN WITH DISABLILITES
- Practice address
- 9772 Diagonal Road
Mantua, OH 44255 - Phone
- (330) 274-2272
- Fax
- (330) 732-2467
- NPI assigned
- Mar 25, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Greg Snyder
- Title
- Cfo
- Phone
- (330) 840-6851
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Hattie Larlham Center for Children With Disabilities
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 0269874 | OH | Yes |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | OH |
Addresses
Primary practice location
9772 Diagonal Road
Mantua, OH 44255
Mailing address
9772 Diagonal Rd
Mantua, OH 44255-9128
Phone (330) 274-2272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0269874 | Medicaid | OH |
Other providers in Mantua, OH
- Hattie Larlham Center for Children With Disabilities
- Hattie Larlham Center for Children With Disablilites
- Hattie Larlham Center for Children With Disablilites
- Hattie Larlham Center for Children With Disablilites
- Hattie Larlham Center for Children With Disablilites
- Chelsea Hepner
- Monica S Honeycutt
- Molly Ohden Jansen
- Victoria Lynn Kaniowski
- Paul Lacher
All providers in Mantua, OH · Intellectual Disabilities Intermediate Care Facility in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.