Healthcare Provider Details

I. General information

NPI: 1982730941
Provider Name (Legal Business Name): HURON COUNTY BOARD OF DD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S NORWALK RD W
NORWALK OH
44857-9529
US

IV. Provider business mailing address

306 S NORWALK RD W
NORWALK OH
44857-9529
US

V. Phone/Fax

Practice location:
  • Phone: 419-668-8840
  • Fax: 419-663-2321
Mailing address:
  • Phone: 419-668-8840
  • Fax: 419-663-2321

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JULIE TYLER
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 419-668-8840