Healthcare Provider Details

I. General information

NPI: 1629192778
Provider Name (Legal Business Name): WARREN COUNTY BD OF DD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 KINGS WAY
LEBANON OH
45036-9593
US

IV. Provider business mailing address

42 KINGS WAY
LEBANON OH
45036-9593
US

V. Phone/Fax

Practice location:
  • Phone: 513-228-6506
  • Fax:
Mailing address:
  • Phone: 513-695-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State

VIII. Authorized Official

Name: MICHELE SWEARINGEN
Title or Position: BUSINESS SERV DIR.
Credential:
Phone: 513-228-6506