Healthcare Provider Details

I. General information

NPI: 1073429312
Provider Name (Legal Business Name): OHIO DEVELOPMENTAL SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 ALPHA DR STE G
HIGHLAND HTS OH
44143-2139
US

IV. Provider business mailing address

675 ALPHA DR STE G
HIGHLAND HTS OH
44143-2139
US

V. Phone/Fax

Practice location:
  • Phone: 216-526-5244
  • Fax:
Mailing address:
  • Phone: 216-630-8185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER C KING III
Title or Position: PRESIDENT
Credential:
Phone: 216-630-8185