Provider Demographics
NPI:1053686022
Name:CHILD DEVELOPMENT DIVISION-HEAD START/EARLY HEAD START
Entity Type:Organization
Organization Name:CHILD DEVELOPMENT DIVISION-HEAD START/EARLY HEAD START
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH NUTRITION DISABILITY COORDIN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LENIGAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-767-4500
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:3 CARDARAS DRIVE
Mailing Address - City:GLOUSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45732
Mailing Address - Country:US
Mailing Address - Phone:740-767-4500
Mailing Address - Fax:740-767-1093
Practice Address - Street 1:3 CARDARAS DR
Practice Address - Street 2:
Practice Address - City:GLOUSTER
Practice Address - State:OH
Practice Address - Zip Code:45732-8011
Practice Address - Country:US
Practice Address - Phone:740-767-4500
Practice Address - Fax:740-767-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH071944252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency