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General NPI Number Information
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NPI Number | 1013131614
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Entity Type | Organization
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Legal Business Name | FAYETTE COUNTY BOARD OF MRDD
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1330 ROBINSON RD SE
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-9201
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Country | US
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Telephone | 740-335-7453
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Fax | 740-335-2185
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Provider Business Mailing Address
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Address Line | 1330 ROBINSON RD SE
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City | WASHINGTON COURT HOUSE
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State | OH
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Zip | 43160-9201
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Country | US
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Telephone | 740-335-7453
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Fax | 740-335-2185
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. STEPHEN HILGEMAN
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Credential |
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Telephone | 740-335-7453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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