Healthcare Provider Details

I. General information

NPI: 1922923515
Provider Name (Legal Business Name): LAWRENCE COUNTY DEVELOPMENTAL DISABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 CARLTON DAVIDSON LANE
COAL GROVE OH
45638
US

IV. Provider business mailing address

604 CARLTON DAVIDSON LANE
COAL GROVE OH
45638
US

V. Phone/Fax

Practice location:
  • Phone: 740-532-7401
  • Fax: 740-532-7356
Mailing address:
  • Phone: 740-532-7401
  • Fax: 740-532-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIE MONROE
Title or Position: SUPERINTENDENT
Credential:
Phone: 740-532-7401