NPI 1174670285

Department of Mental Retardation and Developmental Disabilities

Organisation Intellectual Disabilities Intermediate Care Facility Columbus, OH

Practice location

Address: 1601 W Broad St, Columbus, OH 43222-1054
Phone: (614) 272-0509
Fax: (614) 272-1054
Mailing address: 30 E Broad St, Columbus, OH 43215-3414

Authorised official

Name: D Michael Snow
Title: Superintendent
Phone: (614) 272-0509

Registered specialties (3)

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 2514097 (OH)

Other Intermediate Care Facility, Intellectual Disabilities providers in Ohio →

Mental Illness Intermediate Care Facility

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence 2514097 (OH)

Other Intermediate Care Facility, Mental Illness providers in Ohio →

Intellectual and/or Developmental Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320600000X Licence 2514097 (OH)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Ohio →

Registry record

NPI: 1174670285
Entity type: Organization
NPI issued: 4 Jan 2007
Record last updated: 5 Dec 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.