MEDICARE: SOCIETY FOR HANDICAPPED CITIZENS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility		OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710190855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIETY FOR HANDICAPPED CITIZENS

Provider Business Mailing Address
First Line	:	4283 PARADISE RD
Second Line	:
City	:	SEVILLE
State	:	OH
Zip	:	44273-9353
Country	:	US
Telephone Number	:	330-722-8105
Fax Number	:	330-723-6695

Provider Business Practice Location Address
First Line	:	140 HIGH ST
Second Line	:
City	:	SEVILLE
State	:	OH
Zip	:	44273-9308
Country	:	US
Telephone Number	:	330-722-8105
Fax Number	:	330-723-6695

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MICHAEL BEH
Credential	:
Telephone Number	:	330-722-1900

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	04/16/2018

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