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General NPI Number Information
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NPI Number | 1356564694
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Entity Type | Organization
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Legal Business Name | MORGAN COUNTY BOARD OF MRDD
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 900 S RIVERSIDE DR NE
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City | MC CONNELSVILLE
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State | OH
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Zip | 43756-9102
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Country | US
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Telephone | 740-962-4200
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Fax | 740-962-4435
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Provider Business Mailing Address
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Address Line | 155 E MAIN ST RM 306
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City | MCCONNELSVILLE
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State | OH
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Zip | 43756-1297
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Country | US
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Telephone | 740-962-4200
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Fax | 740-962-4435
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Authorized Official
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Title or Position | BUSINESS DIRECTOR
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Name | AMY KISSINGER
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Credential |
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Telephone | 740-960-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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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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Legacy Identifiers
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Identifier #1
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Identifier Code | 0840040
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Identifier Type | MEDICAID
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Identifier State | OH
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 0840040
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Identifier Type | MEDICAID
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Identifier State | OH
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Identifier Issuer |
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