Provider Demographics
NPI:1164661302
Name:TRUMBULL COUNTY EDUCATIONAL SERVICE CENTER
Entity Type:Organization
Organization Name:TRUMBULL COUNTY EDUCATIONAL SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIMIONE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:330-505-2800
Mailing Address - Street 1:6000 YOUNGSTOWN WARREN RD
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4624
Mailing Address - Country:US
Mailing Address - Phone:330-505-2800
Mailing Address - Fax:330-505-2814
Practice Address - Street 1:6000 YOUNGSTOWN WARREN RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4624
Practice Address - Country:US
Practice Address - Phone:330-505-2800
Practice Address - Fax:330-505-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7800295Medicaid