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General NPI Number Information
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NPI Number | 1134111735
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Entity Type | Organization
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Legal Business Name | MUSKINGUM COUNTY BOARD OF MENTAL RETARDATION AND DEVELOPMENTAL DISABIL
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1304 NEWARK RD
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City | ZANESVILLE
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State | OH
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Zip | 43701-2621
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Country | US
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Telephone | 740-453-4829
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Fax | 740-455-4186
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Provider Business Mailing Address
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Address Line | 1304 NEWARK RD
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City | ZANESVILLE
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State | OH
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Zip | 43701-2621
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Country | US
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Telephone | 740-453-4829
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Fax | 740-455-4186
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. JOHN E. HILL
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Credential |
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Telephone | 740-453-4829
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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 | 6000017
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License Number State | OH
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