Provider Demographics
NPI:1114966512
Name:GEAUGA COUNTY SHERIFFS OFFICE
Entity Type:Organization
Organization Name:GEAUGA COUNTY SHERIFFS OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHERIFF
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCCLELLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-279-2068
Mailing Address - Street 1:12450 MERRITT ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9010
Mailing Address - Country:US
Mailing Address - Phone:440-279-2009
Mailing Address - Fax:440-286-3251
Practice Address - Street 1:12450 MERRITT ROAD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9010
Practice Address - Country:US
Practice Address - Phone:440-279-2009
Practice Address - Fax:440-286-3251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3144OtherDEPT ALCOHOL & DRUG ADDIC