Healthcare Provider Details

I. General information

NPI: 1093902140
Provider Name (Legal Business Name): COUNTY OF RICHLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 WOODVILLE RD
MANSFIELD OH
44907-2167
US

IV. Provider business mailing address

314 CLEVELAND AVE
MANSFIELD OH
44902-8623
US

V. Phone/Fax

Practice location:
  • Phone: 419-522-4368
  • Fax:
Mailing address:
  • Phone: 419-774-4200
  • Fax: 419-774-4207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH G PRATHER
Title or Position: SUPERINTENDENT
Credential:
Phone: 419-774-4200