Healthcare Provider Details

I. General information

NPI: 1114966512
Provider Name (Legal Business Name): GEAUGA COUNTY SHERIFFS OFFICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12450 MERRITT ROAD
CHARDON OH
44024-9010
US

IV. Provider business mailing address

12450 MERRITT ROAD
CHARDON OH
44024-9010
US

V. Phone/Fax

Practice location:
  • Phone: 440-279-2009
  • Fax: 440-286-3251
Mailing address:
  • Phone: 440-279-2009
  • Fax: 440-286-3251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL C MCCLELLAND
Title or Position: SHERIFF
Credential:
Phone: 440-279-2068