Healthcare Provider Details

I. General information

NPI: 1568462000
Provider Name (Legal Business Name): FULTON COUNTY BOARD OF DD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 N OTTOKEE ST
WAUSEON OH
43567-1906
US

IV. Provider business mailing address

1210 N OTTOKEE ST
WAUSEON OH
43567-1906
US

V. Phone/Fax

Practice location:
  • Phone: 419-337-4575
  • Fax: 419-335-3082
Mailing address:
  • Phone: 419-337-4575
  • Fax: 419-335-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number2600019
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number2600019
License Number StateOH

VIII. Authorized Official

Name: MISS BRENDA OYER
Title or Position: SUPERINTENDENT
Credential:
Phone: 419-337-4575