Healthcare Provider Details

I. General information

NPI: 1568687622
Provider Name (Legal Business Name): BELMONT COUNTY BOARD OF DEVELOPMENT DISABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68421 HAMMOND ROAD
ST. CLAIRSVILLE OH
43950-8783
US

IV. Provider business mailing address

68421 HAMMOND ROAD
ST. CLAIRSVILLE OH
43950-8783
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-0407
  • Fax: 740-695-7427
Mailing address:
  • Phone: 740-695-0407
  • Fax: 740-695-7427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: GLORIA LLEWELLYN
Title or Position: ASSISTANT SUPERINTENDENT
Credential:
Phone: 740-695-0407