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General NPI Number Information
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NPI Number | 1386517407
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Entity Type | Organization
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Legal Business Name | KOINONIA DEVELOPMENT CENTER
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 6810 CORK COLD SPRINGS RD
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City | GENEVA
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State | OH
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Zip | 44041-9346
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Country | US
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Telephone | 440-207-0629
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Fax |
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Provider Business Mailing Address
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Address Line | 6810 CORK COLD SPRINGS RD
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City | GENEVA
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State | OH
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Zip | 44041-9346
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Country | US
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Telephone | 440-207-0609
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | ANGELINA GILL
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Credential | OTR/L
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Telephone | 440-207-0609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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