Healthcare Provider Details

I. General information

NPI: 1821290099
Provider Name (Legal Business Name): WILLIAMS COUNTY BOARD OF MRDD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11246 STATE ROUTE 15
MONTPELIER OH
43543-9282
US

IV. Provider business mailing address

11246 STATE ROUTE 15
MONTPELIER OH
43543-9282
US

V. Phone/Fax

Practice location:
  • Phone: 419-485-8331
  • Fax: 419-485-5495
Mailing address:
  • Phone: 419-485-8331
  • Fax: 419-485-5495

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

VIII. Authorized Official

Name: MR. JEROME MANUEL
Title or Position: SUPERINTENDENT
Credential:
Phone: 419-485-8331