SOUTHWEST OHIO DEVELOPMENTAL CENTER NPI 1124180658

NPI Information

NPI: 1124180658
Provider Name: SOUTHWEST OHIO DEVELOPMENTAL CENTER

Other Name: SODC

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

Address:
4399 E BAUMAN LN
BATAVIA, OH
ZIP 45103
Phone: (513) 732-9200
Get Directions

SOUTHWEST OHIO DEVELOPMENTAL CENTER is an intermediate care facility mentally retarded in Batavia, OH. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. SOUTHWEST OHIO DEVELOPMENTAL CENTER NPI is 1124180658. The provider is registered as an organization entity type.
The provider Other Name Is Sodc.

The provider's business location address is:

4399 E BAUMAN LN
BATAVIA, OH
ZIP 45103-685
Phone: (513) 732-9200
Fax: (513) 735-8232

The provider's authorized official is James C. Krumer .
The authorized official title is Superintendent and has the following contact phone number (513) 732-9200.

The CLIA number assigned to this NPI record is 36D0956037 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 8/30/2010.

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	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		1310875	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	2423694	MEDICAID	OHIO
2	9338743	MEDICARE PIN	OHIO
3	1310875	OTHER	OHIO	MRDD LICENSE 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

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