PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT NPI 1639164205

NPI Information

NPI: 1639164205
Provider Name: PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization

CLIA Number: 36D0857910

Address:
7008 STATE ROUTE 88
RAVENNA, OH
ZIP 44266
Phone: (330) 296-2839
Get Directions

PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT is a day training developmentally disabled services in Ravenna, OH. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. PORTAGE COUNTY BOARD OF DEVELOPMENTAL DISABILIT NPI is 1639164205. The provider is registered as an organization entity type.

The provider's business location address is:

7008 STATE ROUTE 88
RAVENNA, OH
ZIP 44266-188
Phone: (330) 296-2839
Fax: (330) 297-8875

The provider's authorized official is Omar Nagi .
The authorized official title is Superintendent and has the following contact phone number (330) 297-6209.

The CLIA number assigned to this NPI record is 36D0857910 - other - health dist and wic clin with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2005 and was last updated on 9/22/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	252Y00000X	Early Intervention Provider Agency		OHIO	No
2	347B00000X	Bus	2560072	OHIO	No
3	251B00000X	Case Management	0776129	OHIO	No
4	344600000X	Taxi	2560072	OHIO	No
5	347C00000X	Private Vehicle	2560072	OHIO	No
6	251K00000X	Public Health or Welfare	2560072	OHIO	No
7	251E00000X	Home Health	2560072	OHIO	No
8	251S00000X	Community/Behavioral Health	2560072	OHIO	No
9	251C00000X	Day Training, Developmentally Disabled Services	2560072	OHIO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6700010	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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